THE  LIBRARY 

OF 

THE  UNIVERSITY 
OF  CALIFORNIA 

PRESENTED  BY 

PROF.  CHARLES  A.  KOFOID  AND 
MRS.  PRUDENCE  W.  KOFOID 


LINDSAY  &  BLAKISTON, 

PHILADELPHIA, 

PUBLISH 

HOPE'S  PATHOLOGICAL  ANATOMY. 

ADAPTED  TO 

FORBES,   TWEEDIE,   CONOLLY,  AND   DUNGLISON'S   CYCLO- 
PEDIA OF  PRACTICAL  MEDICINE  AND  AJNDRAL'S 
ELEMENTS. 

With  two  hundred  and  sixty  beautifully  colored  illustrations. 

Edited  by  L.  M.  LAWSON,  M.  D., 
Professor  of  General  and  Pathological  Anatomy  in  the  Transylvania  University. 

The  additions  to  the  text  made  by  the  American  editor,  are  judicious,  and  in 
keeping  with  the  plan  and  spirit  of  the  original.  Dr.  Lawson  has  succeeded  in 
obtaining  very  accurate  fac  similes  of  the  illustrations,  by  which  the  work  ia 
accompanied  ;  the  execution  of  which  is  but  little  inferior  to  those  of  the  London 
edition.  The  execution  of  the  work  throughout  does,  in  fact,  great  credit  to  its 
editors  as  well  as  publishers,  and  we  trust  that  their  very  commendable  enter- 
prise mny  be  rewarded  by  a  ready  sale  of  the  correct  and  beautiful,  and,  at  the 
same  time,  cheap  edition  they  have  presented  to  the  profession  of  the  very 
valuable  treatise  of  Dr.  Hope. — American  Journal  of  the  Medical  Sciences. 


THE  PRINCIPLES  OF  PATHOLOGY 

AND  PRACTICE  OF  MEDICINE. 

BY  JOHN  MACKINTOSH,  M.  D.,  &c. 

Fourth  American,  from  the  last  London  edition,  with  notes  and  additions, 

By  SAMUEL  GEORGE  MORTON,  M.D.,  &c. 

In  one  volume,  8vo. 

That  this  volume  should  have  passed  to  a  fourth  edition  in  this  country,  is  a 
strong  proof  of  its  popularity.  It  is  a  valuable  epitome  of  medical  practice, 
founded  upon  the  most  approved  pathology,  the  state  of  which  at  the  present 
day  it  very  accurately  represents.  No  better  book  can  be  purchased  by  the 
student  than  this.  The  author  was  a  man  of  great  learning,  indefatigable  zeal, 
and  extensive  practice.  As  a  pathologist  he  was  able,  warm  and  enthusiastic. 
He  writes  agreeably,  with  clearness  and  vigor,  and  his  book  bears  the  marks 
at  once  of  thought,  close  and  correct  observation,  ample  experience,  and  accu- 
rate knowledge  of  past  and  actual  pathology.  The  American  editor  has  added 
much  valuable  matter.  The  work  is  one  of  the  most  useful  text-books  on  the 
subject  of  which  it  treats,  extant  in  our  tongue,  and  should  be  in  the  hands  of 
every  student,  and  on  the  shelves  of  every  medical  library. — New  York  Journal 
of  Medical  Science. 


EARTH  AND  ROGERS' 
MANUAL  OF  AUSCULTATION  AN3  PERCUSSION, 

TRANSLATED,    WITH    ADDITIONS, 
BY  F.  G.  SMITH,  M.  D., 

Lecturer  on  Physiology,  Fellow  of  the  College  of  Physicians,  &c. 
A  small  pocket  volume  for  the  Practitioner  and  Student. 

This  Manual  is  strictly  elementary,  and  is  so  arranged  as  to  convey  to  the 
Student  an  accurate,  yet  condensed  view  of  Auscultation  and  Percussion  in  their 
most  extended  applications.  Plain  and  simple  rules  are  given  by  which  the 
merest  tyro  may  become  an  expert  Auscultator;  we  would  strongly  recommend 
it  to  the  Student  who  wishes  to  become  familiar  with  the  elements  of  this  depart- 
ment. The  translator  has  evinced  judgment  and  ability. —  Western  Lancet. 

This  is  a  very  useful  manual  of  the  most  important  diseases  of  the  chest  and 
abdomen,  which  we  cheerfully  commend  to  all  who  wish  to  cultivate  the  indis- 
pensable department  of  physical  diagnosis. — IV.  Y.  Med.  and  Surg.  Journal. 

We  commend  this  little  Manual  to  the  Student  and  to  the  Physician,  it  comes 
from  the  proper  source  and  is  well  translated. — Jour,  of  Dental  Science. 


THE  MEDICAL  EXAMINER 


AND 


RECORD  OF  MEDICAL  SCIENCE, 

NEW  AND  ENLARGED  SERIES. 

Published  Monthly,  each  Number  containing  72  handsomely  printed 
octavo  pages,  or  864  pages  per  annum,  the  year  commencing  with 
January. 

EMBRA  CING 

Original  Articles  by  some  of  the  most  Eminent  Men  in  the  Profession  ;  Re- 
views and  Notices  of  all  New  Works  on  Medicine  and  the  Col- 
lateral Sciences  ;  together  with  a  complete  record 
of  all  that  is  new  or  valuable  in 

Medicine. 
WITH  OCCASIONAL  WOODCUT  ILLUSTRATIONS. 

Edited  by  ROBERT  ML  HUSTON,  M,  D,, 

Professor  of  Materia  Medica  and  General  Therapeutics  in  the  Jefferson  Medical  Col- 
lege, President  of  the  Philadelphia  Medical  Society,  &c.  &c. 

TERJfIS  Or  SUBSCRIPTION. 

Three  dollars  per  annum ;  two  copies  for  five  dollars,  five  copies  for 
ten  dollars,  or  two  years  to  any  subscriber  remitting  five  dollars  in 
advance. 


PRINCIPLES  AND  PRACTICE  OF  DENTAL  SURGERY, 

Revised,  improved  and  greatly  enlarged. 

ILLUSTRATED   BY  NUMEROUS  WELL  EXECUTED  ENGRAVINGS. 

In  one  volume. 

The  members  of  the  profession,  and  students  in  particular,  have  long  felt  the 
necessity  of  a  treatise  on  Dentistry,  in  all  its  branches,  medical,  surgical  and 
mechanical,  which  should  at  once  be  comprehensive  in  its  scope,  practical  in 
its  detail,  correct  in  its  science  and  beautiful  in  typographical  execution.  This 
desideratum  is  now  supplied  in  a  manner  highly  creditable  to  the  accomplished 
author,  and  peculiarly  acceptable  to  the  profession  at  large. 

Dr.  Harris  has  proved  himself  so  well  qualified  for  his  task,  that  it  may  be 
safely  asserted  that  no  one  volume  in  the  English  language  contains  an  equal 
amount  of  correct  and  valuable  information  for  the  use  of  the  student  in  dentistry. 
There  are  manifested  also  in  Dr.  Harris's  volume  an  originality  of  thought  and 
an  independence  of  opinion  equally  calculated  to  elicit  truth  and  to  expose 
error. — Journ.  of  Dental  Surgery. 


THE  SURGICAL  AND  MECHANICAL  TREATMENT 

<BB?  ^nim  'jjiaiB'ffliEu 

INCLUDING   DENTAL   MECHANICS. 

WITH  ONE  HUNDRED  AND  THIRTY-NINE  ILLUSTRATIONS. 

BY    JAMES    ROBINSON, 

Surgeon-Dentist  to  the  Metropolitan  Hospital,  &c.  &c. 

A  superior  book,  beautifully  printed  on  fine  paper,  with  numerous  well  executed 
illustrations,  in  one  12mo.  volume. 


ARTHUR'S  MANUAL  OF  THE  DISEASES 
OF    THE    TEETH. 

WITH   A   DESCRIPTION   OF  THEIR  STRUCTURE,  MODES   OF 
TREATMENT,  &c.  &c. 

A  SMALL  POCKET  VOLUME. 

This  is  a  good  manual,  and  comprises  all  that  is  necessary  for  the  genera* 
reader  and  practitioner  of  medicine  to  know  on  the  subject,  and  being  written 
in  a  plain  and  perspicuous  style,  without  the  unnecessary  use  of  technicalities, 
is  adapted  to  readers  of  every  class. — Med.  Examiner. 

It  gives  us  pleasure  to  state  that  we  have  seldom  read  a  popular  treatise  on 
the  Teeth,  that  contains  so  much  useful  and  valuable  information  as  does  this. 
It  is  a  work  which  every  family  should  have,  and  we  can  recommend  it,  too,  to 
the  members  of  the  Dental  Profession  as  well  worthy  of  perusal. — Dental  Intelli- 
gencer. 

It  gives  us  pleasure  to  announce  the  publication  of  this  work  which  we  regard, 
so  far  as  we  have  had  an  opportunity  of  examining  it,  as  one  of  the  best  popular 
treatises  on  the  subject  extant.  As  a  literary  production  it  is  highly  creditable 
jo  its  author. — Amer.  Jour,  of  Dental  Science. 


MEIGS'  VELPEAU'S  MIDWIFERY. 

THIRD  EDITION,  REVISED,  WITH  ADDITIONS, 
BY  WM,  HARRIS,  M.  D. 

We  have  chosen  this^  because  it  appears  to  us  to  be  one  of  the  very  best.  It 
is  a  model  for  such  a  work  ;  the  several  parts  being  duly  connected,  related, 
and  managed  with  a  beautiful  simplicity  and  dexterity,  like  that  used  by  the 
naturalist.  A  sort  of  nomenclatural  neatness  and  conciseness  reigns  throughout. 
It  is  a  book  that  no  physician  should  be  without — N.  A.  Medical  Journal. 

This  very  able  work  on  Midwifery  has,  for  years,  been  a  text-book  for  the 
profession,  being  unrivalled  amongst  the  numerous  similar  volumes  that  have 
issued  from  the  press,  in  the  different  countries  of  Europe  and  the  western 
world.  Velpeau  is,  at  the  present  moment,  one  of  the  greatest  medical  lumi- 
naries of  the  age.  A  prolific  writer,  he  has  adorned  almost  every  department  of 
the  healing  art,  surgical  and  medical,  with  his  numerous  publications*  The 
science  of  Obstetrics  in  his  hands  acquires  fresh  interest,  from  the  valuable  sug- 
gestions, hints  and  conclusions  with  which  he  has  enriched  it.  No  accoucheur 
should  be  without  a  copy  of  this  treatise. — New  Orleans  paper. 


THE    WRITINGS    OF 

HIPPOCRATES  AND  GALEN, 

EPITOMIZED  AND  RENDERED  INTO  ENGLISH 
BY  JOHN  REDMAN  COXE,  M.  D. 

PUBLISHERS'     NOTICE. 

Dr.  Coxe,  having  translated  the  writings  of  these  fathers  in  Medicine,  has 
epitomized  them  in  such  a  way  as  he  deemed  most  expedient,  in  order  to  afford 
to  the  Profession  a  brief  exposition  of  their  contents  :  some  of  the  Treatises  are 
given  in  full;  most  of  them,  however,  would  be  considered  superfluous,  and  are 
far  too  voluminous  for  the  perusal  of  those  members  of  the  Profession  who  are 
engaged  in  its  active  duties.  There  are,  probably,  few  physicians  who  would 
not  desire  to  trace  an  outline  of  the  writings  of  two  men  who  have  always  held 
such  high  rank,  of  whom  so  much  is  said  both  in  books,  in  conversation  and  in 
every  school  of  medicine. 

THE  AMERICAN  MEDICAL  ALMANAC, 

OR, 

Physician's  and  Student's  Guide: 

CONTAINING  VALUABLE  STATISTICAL  AND  OTHER  INFOR- 
MATION;  TO  BE  ISSUED  IN  THE  FALL  OF  1847, 
AND  CONTINUED  ANNUALLY. 


MENDENHALL'S  MEDICAL  STUDENT'S  VADE  MEDUM, 

OR, 

MANUAL   OF   EXAMINATIONS 

IN  ANATOMY,   PHYSIOLOGY,    SURGERY,   OBSTETRICS,  THE 
PRACTICE  OF  MEDICINE,  CHEMISTRY,  &c 

A  neat  Pocket  Volume. 


HANDBOOK 


OF 


HUMAN    ANATOMY, 


I 


GENERAL,  SPECIAL,  AND  TOPOGRAPHICAL. 


TRANSLATED    FROM    THE    ORIGINAL    GERMAN 


DK.  ALFRED  VON  BEHR, 

AND  ADAPTED  TO  THE  USE  OF  THE  ENGLISH  STUDENT, 


..      -*        .  '.'     - 


JOHN   BIRKETT 


FELLOW  OF  THE  ROTAL  COLLEGE  OF  SURG 
D 


OSSTRATOR  OF  AXATOSY  AT  GV 

( 


PHILADELPHIA: 

LINDSAY   AND   BLAKISTON. 

1847. 


i 


PHILADELPHIA  : 

T.  K.  AND  P.  G.  COLLINS, 

PRINTERS. 


• 


- 

TO 


STUDENTS  OF  ANATOMY, 


THE  FOLLOWING  PAGES  ARE  INSCRIBED 


BY 


THE  TRANSLATOR 


London,  October,  1846. 


THE  AUTHOK'S  PREFACE. 


THE  "  Pocket-book  of  Anatomy"  is  intended  to  afford  the  Student  a  short 
and  comprehensive  detail  of  anatomical  facts,  suited  to  the  practical  tendency 
of  the  "  Medical  Encyclopaedia."*  It  may  serve  either  as  an  introduction  to 
the  study  of  Anatomy,  or  for  refreshing  the  memory,  more  especially  of  those 
preparing  for  examinations.  With  this  view,  the  relations  which  Anatomy 
bears  to  Physiology,  Pathology,  and  Surgery,  have  been  considered  in  an  espe- 
cial manner,  either  tacitly  intimated,  or  expressly  mentioned;  but  critical  and 
useless  observations  have  been,  as  far  as  appeared  practicable,  disregarded. 

Our  German  Handbooks  and  introductions  (especially  that  of  C.  A.  Bock) 
have  only  very  lately  attempted  to  appropriate,  from  the  French,  the  advan- 
tages of  a  clear,  summary,  and  agreeable  detail ;  the  author  of  the  Pocket- 'xx)k 
also  thinks  that  he  might  take  the  latter  as  a  model  for  his  work  without  dero- 
gating from  the  much-prized  German  profoundness.  We  trust  we  shall  not 
be  misunderstood,  as  though  we  were  going  to  encourage  an  unscientific 
superficiality.  On  the  contrary,  we  wish  that  the  science  were  seriously  con- 
sidered, and  that  the  trouble  which  the  mere  elements  require,  increasing,  as 
it  does  daily,  with  the  growth  of  materials,  may  not  be  unnecessarily  en- 
hanced, but  applied  to  that  which  is  really  useful. 

The  science  of  Physiology  and  Anatomy  has,  since  the  year  1838,  received 
so  important  an  elevation  in  consequence  of  Schwann's  cell  theory,  that  the 
author  does  not  hesitate  to  take  it  as  the  foundation  of  his  work,  and  he  chiefly 
refers  for  farther  study  to  the  admirable  work  of  Henle  (Sommerring,  Jttlgt- 
meine  dnatomie,  ed.  Henle). 

In  the  special  anatomy,  the  author,  although  aiming  at  the  greatest  brevity, 
saw  the  necessity  of  frequent  repetitions,  which,  although  of  use  to  the  Stu- 
dent, are  detrimental  to  the  uniformity  of  the  book ;  which,  by  the  utmost 
precision  in  doubtful  points,  by  greater  amplitude  in  some  sections,  by  the 
statement  of  numerical  determinations,  by  tabular  views,  and  by  the  addition 
of  the  Topographical  portion  and  the  situs  mscerum,  he  tried  to  give  it,  and  thus 
to  make  it  preferred  to  similar  pocket-books, 

*  See  Translator's  Preface. 


TRANSLATOR'S  PREFACE. 


THE  following  pages  have  been  translated  from  one  of  a  series  of  volumes, 
entitled  "  The  Pocket  Encyclopaedia  of  the  Medical  Sciences,"  by  Dr.  von 
Behr  and  Dr.  Minding,  and  now  in  course  of  publication  at  Erlangen. 

The  translator  has  long  experienced,  in  his  daily  intercourse  with  students, 
the  disadvantages  under  which  they  labour  from  the  want  of  a  really  ele- 
mentary work  on  Anatomy, — one  which  would,  by  giving  a  well-defined 
outline  of  the  subject,  lead  them  to  fill  up  the  picture  from  the  book  of  Na- 
ture, or  more  elaborate  and  highly  finished  works.  Of  such  books  the  Student 
has,  now,  as  many  as  he  can  desire,  but  their  size,  beauty,  or  prolixity,  render 
them  better  adapted  for  reference  than  as  class  books  for  their  course  of  study. 
This  translation  was,  therefore,  undertaken  in  the  hope  that  it  might  lead  to 
an  assiduous  and  earnest  study  of  the  subject  in  the  dissecting-room,  and  not 
with  the  view  of  superseding  the  diligent  prosecution  of  the  inquiry  by  means 
of  dissections, — the  only  mode  in  which  an  accurate  and  available  acquaintance 
with  the  structure  and  arrangement  of  the  organs  of  the  body  can  be  acquired. 

To  assist  the  Student,  however,  in  the  literature  of  the  science,  references 
have  been  made  at  the  head  of  each  division  of  the  work,  to  such  monographs 
in  the  English  language  as  contain  original  observations. 

The  translator  has  made  additions  in  a  few  places,  which  are  thus  indi- 
cated [  •  ~] ;  and  in  the  Topographical  portion  he  has  given  such  instructions 
as  he  considers  most  suitable  for  the  display,  by  dissection,  of  the  parts  de- 
scribed. 

The  abbreviations  in  the  body  of  the  work  were  adopted  as  consistent  with 
the  intention  of  the  book ;  namely,  to  embrace  as  great  a  number  of  facts  in 
as  small  a  space  as  possible. 

The  marks  '  , ff  , r" ,  express,  successively — a  foot, — an  inch, — a  line. 
The  translator  does  not  concur  in  all  the  observations  made  by  the  author. 

Should  this  translation  be  found  useful  to  the  Student,  other  volumes  of  the 
series  will,  perhaps,  be  published. 

London,  October  1846. 


ANATOMY. 


"Along  with  the  observation  of  the  living  person,  the  more  searching 
examination  which  could  be  carried  on  in  the  dead  body,  and  the  comparison 
of  various  kinds  of  animals,  soon  showed  that  this  pursuit  was  rich  in  know- 
ledge and  interest.  Moreover,  besides  the  interest  which  the  mere  speculative 
faculty  gave  to  this  study,  the  art  of  healing  added  to  it  a  great  practical 
value,  and  the  effects  of  diseases  and  of  medicines  supplied  new  materials 
and  new  motives  for  the  reasonings  of  the  philosopher." — WHEWELL.  Hist, 
of  the  Inductive  Sciences. 

"  The  most  simple  mode  of  investigating  an  animal  body  is  first  to  consider 
the  matter  of  which  it  is  composed." — HUKTER. 


LITERATURE  : 

Anatomy : — General  and  Descriptive : — 

Elements  of  Anatomy.    By  Jones  Quain,  M.  D.    5th  edition,  illustrated.     1843. 
Descriptive   Anatomy.     By  J.  Cruveilhier,   2    vols.     Library   of  Medicine. 

1841. 
Lectures   on   Anatomy,   interspersed   with   practical   Remarks.     By   B.   B. 

Cooper,  F.  R.  S. 
The  Cyclopaedia  of  Anatomy  and  Physiology.    Edited  by  Robt  Todd,  M.  D., 

F.  R.  S. 
Reports  on  the  chief  Results  obtained  by  the  Use  of  the  Microscope  in  the 

Study  of  Human  Anatomy  and  Physiology.     By  James  Paget.     Brit,  and 

For.  Med.  Rev.  1842.     Part  First,  and  continued. 
Schwann.     "Microscopical  Observations  upon  the  Accordance  in  the  Structure 

and  Growth  of  Animals  and  Vegetables."     A  translation  of  which  is  to 

appear  among  the  volumes  of  the  Sydenham  Society. 
Horner's  Special  and  General  Anatomy.    2  vols.    5th  edit.  1839.     For  tensor 

tarsi.     Vol.  ii.  p.  407.     Also  the  Muscles  of  the  Rectum. 
Gerber.     General  Anatomy.     Translated  by  Gulliver,  1841.     Text,  plates. 
/,  Muller.     The  intimate  Structure  of  the  Secreting  Glands.     Translated  by 

S.  Solly,  F.  R.  S.     Plates.    1839. 

Bowman.     Art.  "  Mucous  Membrane"  in  Cyclopaedia  of  Anatomy,  with  Biblio- 
graphical References. 
Goodsir,  John  and  Harry.     Anatomical  and  Path.  Obs.  1845.     Chap.  "Centres 

of  Nutrition."     Also,  "Structure  of  the  Lymphatic  Glands,"  p.  44. 
Beclard.     Elements  of  General  Anatomy.     Knox,  1830. 


LITERATURE. 

Craigie.     Elements  of  General  Anatomy.     1828. 

Henle.     General  Anatomy.     The  French  translation. 

Quekett,  J.     Obs.  on  Structure  of  Bat's  Hair.     Microscop.  Trans,  vol.  i.  p.  58. 

On  the  Movement  of  the  Cilia  in  the  common  Mussel  (Mytilus 

Eclulis).     Microscop.  Trans,  vol.  ii. 

Physiology : — 

Hatter.     Elementa  Physiologise.     4to.  1757. 

A  Manual  of  Physiology,  &c.     By  W.  B.  Carpenter,  M.D.,  F.  R.  S.,  with  illus- 
trations.    1846. 

Hunter.     Rem.  on  Fat.     Catal.  of  Museum,  vol.  iii. 
Principles  of  General  and  Comparative  Physiology.     By  W.  B.  Carpenter, 

M.  D.     Last  edition. 

Principles  of  Human  Physiology.     By  the  same  Author.     Last  edition. 
An  Elementary  System  of  Physiology.     By  John  Bostock,  M.  D.,  F.  R.  S.    3d 

edit.  vol.  i.  1836. 

Rudiments  of  Physiology.     By  John  Fletcher.     1837. 
Elements  of  Physiology-   By  J.  Miiller,  M.  D.    Translated  by  W.  Baly,  M.  D. 

2d  edition. 

Elements  of  Physiology.  By  R.  Wagner,  M.  D.  Translated  by  R.  Willis,  M.  D. 
Life.     Art.  Cycl.  of  Anat.  and  Phys.     Bibliography  at  the  end. 
Dutrochet.    Art.  "Endosmose."     Cycl.  Anat.  and  Phys. 
Alison.     Outlines  of  Physiology  and  Path.     1831 — 1833. 
Barclay.     On  Life  and  Organization.  8vo. 
Bell,  Sir  C.     Anat.  and  Phys.  of  the  Human  Body.     1823. 
Davy,  J.     Phys.  and  Anat.  Researches.     2  vols.     1839. 
Elliotsoris  Human  Physiology.     1840. 
Articles  in  the  Cyclopaedia  of  Anatomy,  &c. 
Hewson,  W.     Experimental  Enquiries  into  the  Blood,  &c.     8vo.  1772 — 1777. 

Also,  his  Works.     Edited  by  G.  Gulliver,  Esq.,  Sydenham  Society. 
G.  O.  Rees  and  S.  Lane.     On  the  Structure  of  the  Blood  Corpuscle.     Guy's 

Hosp.  Rep.  vol.  vi. 
Coste.     Researches  on  the  Primary  Modifications  of  Organic  Matter,  and  on 

the  Formation  of  Cells.     Ann.  and  Mag.  of  Nat.  Hist.  vol.  xvi.  p.  377. 
Nasmyth.     Memoirs  on  the  Development  of  the  Teeth  and  Epithelium,  1841, 

and  Brit.  Association  Reports,  1839. 
Himter,  J.  On  the  Blood.  4to.  1793. 
Thackrah.  An  Inquiry  into  the  Nature  and  Properties  of  the  Blood  in  Health, 

&c.     1819. 

Animal  Chemistry : 
J.  F.  Simon.     Animal  Chemistry,  &c.     Translated  by  G.  E.  Day,  M.  A.  and 

L.  M.  Cantab.     1845.     Printed  for  the  Sydenham  Society. 
J".  Liebig.    Animal  Chemistry,  &c.     Translated  by  W.  Gregory,  M.  D.  A  new 

edition. 
G.  O.  Rees,  M.  D.     On  the  Analysis  of  the  Blood  and  Urine  in  Health,  &c. 

The  new  edition. 
••  Fluoric  Acid  an  Ingredient  in  certain  Animal  Matters.     Guy's 

Hosp.  Rep.  vol.  iv.  p.  381. 
Arsenic  as  a  Natural  Constituent  of  Human  Bones.     Guy's  Hosp. 

Rep.  vol.  vi. 


HANDBOOK 


OF 


HUMAN  ANATOMY, 


L  ANATOMY  (avattfjivfiv,  to  dissect)  has  for  its  object  a  know- 
ledge of  the  separate  parts  of  organic  bodies.  Every  organismus 
consists  of  a  series  of  different  parts  (organs)  associated  together 
with  a  view  to  the  maintenance  and  self-preservation  of  the  whole, 
which,  likewise,  proceed  from  the  connection  of  dissimilar  struc- 
tures (tissues).  The  consideration  of  the  tissues,  their  form, 
development,  and  constituents,  belongs  to  the  general  part  of  ana- 
tomy ("  Anatomy  of  Tissues,"  Histologici),  a  science,  for  the 
foundation  of  which  we  have  to  thank  Bichat  (born  1771,  died 
1802),  and  for  the  farther  advance  of  which  we  are  indebted  to 
the  labours  of  more  modern  inquirers.  A  description  of  the 
organs  forms  the  particular  part,  Special  Anatomy. 

GENERAL  ANATOMY. 

2.  The  animal  body  consists  of  solid  and  fluid  substances, 
which,  permeating  one   another,  may,  by  chemical   means,  be 
resolved,  into  proximate  and  ultimate  elements,  and  supply  the 
material  base  to  the  forms  of  the  elementary  constituents  and 
tissues. 

I.  CONSTITUENTS  OF  THE  HUMAN  BODY. 

3.  The   17 — 19  bases  which  the  chemist  recognises  in  the 
tissues  and  fluids  of  the  healthy  human  body,  are : — 

Oxygen,  Hydrogen,  Carbon,  Nitrogen ;  Phosphorus,  Sulphur,  Chlorine,  Flu- 
orine ;  Potassium,  Sodium ;  Calcium,  Magnesium,  Silicium,  Aluminum ;  Iron, 
Manganese,  Titanium,  and  (according  to  Raspail)  Arsenic,  Copper. 

Of  these  Oxygen,  Hydrogen,  Carbon,  and  Nitrogen  form  the  principal  rrass 
of  the  fluids  and  soft  tissues  ;  Lime  (as  phosphate  and  carbonate  of  lime) 
that  of  the  bones ;  the  rest  are  found  in  smaller  quantities  only.  A  few  of 


18  GENERAL  ANATOMY. 

them  are  present  in  a  pure  state  (Nitrogen  and  Oxygen  in  the  blood,  Nitrogen 
in  the  intestinal  gases),  the  rest  in  binary,  ternary,  and  quarternary  com- 
pounds. 

4.  Binary,  called  inorganic  compounds : — 

1.  Water;  composes  the  largest  part  of  all  animal  fluids,  permeates  most 
solid  parts,  giving  rise  to  their  various  degrees  of  softness. 

2.  Carbonic  Add-  in  blood,  urine,  the  exhalations  from  the  lungs,  and  the 
cutaneous  transpiration;  in  their  salts. 

a.  Carbonates ;  of  Potassa  in  Serum. 

b.  Soda,  in    Serum,  Haematin,  Bile,  liq.  JLmnios,   Mucus,    Sweat, 

Saliva,  Tears  ;  Cartilage,  Bone,  Teeth. 

c.  Ammonia,  in  Urine  and  liq.  JLmnws. 

d.  « Lime,  in  Cartilage,  Bones,  Teeth,  Sand  of  ear,  Nails. 

e.  • Magnesia  in  grease  of  the  skin. 

3.  Pkosphatic  Salts: — 

a.  Soda  in  Serum,  Haematin,  Bile,  liq.  Jlmnias,  Urine,  Sweat,  Saliva, 

Tears ;  Nails,  Cartilage,  Muscles. 

b.  • •  Lime  in  Bones,  Cartilages,  Teeth,  sand  of  Pineal  gland. 

c.  Soda  and  Ammonia  in  Urine  ;  Blood  (Hiinefeld). 

d.  Oxide  of  Iron  in  Haematin,  Gastric  juice,  Urine. 

4.  Chlorine  Compounds: — 

a.  Hydrochloric  acid  in  the  fluid  of  the  stomach  and  Caecum. 

b.  Chloride  Sodium  in  Blood  and  Secretions ;  Brain,  Muscles,  Bone,  Car- 

tilage, Teeth,  Pigment  of  eyes. 

o.  Chloride  of  Potassium  in  Blood,  Crystalline  lens,  Saliva,  Gastric  juice, 
Urine,  Milk. 

d.  Chloride  of  Ammonium  in  Urine,  Sweat,  Gastric  juice. 

e.  Chloride  of  Calcium  in  Gastric  juice. 

5.  Sulphates: — 

a.  Potash  in  Urine,  Gastric  juice,  Cartilage. 

b.  Soda  in  Urine,  liq.  Jlmnios  ;  Sweat,  Bile,  Cartilage. 

c.  Lime  in  liq.  Jlmnios ;  Bile,  Gastric  juice,  Hair,  Epidermis. 

6.  Sulpho-cyanide  of  Potassium  in  the  Saliva. 

7.  Fluoride  of  Calcium  in  enamel  of  teeth. 

8.  Silica  and  Oxide  of  Manganese  in  Hair. 

9.  Alumina  in  enamel  of  teeth,  Bones  (?)  and  white  hair  (?). 

1 0.  Oxide  of  Iron  in  Hsematin,  black  Pigment,  Lens,  and  Hair. 

11.  Oxide  of  Titanium  in  the  supra  renal  capsules.  (Rees.) 

•Ammonia  (Nitrogen,  Hydrogen)  and  Cyanogen  (Nitrogen,  Carbon)  do 
not  exist  in  a  free  state  in  the  organism,  but  as  compound  salts,  and 
even  then  in  excreted  substances  only  (Urine,  Sweat,  Saliva). 

Compounds  exist  likewise  of  inorganic  bases  with  organic  acids. 
(See  Urine,  Milk,  Oil,  Mar  gar  ic  acid.) 

5.  How  the  ternary  and  quarternary  compounds  of  the  ele- 
ments which  constitute  the  proper  organic  mass  are  brought  about, 
lias  not  been,  hitherto,  ascertained  by  inorganic  chemistry,  because 
it  is  not  possible  to  analyse  them  in  the  common  binary  com- 
pounds, or  to  compose  them  from  these.  The  most,  besides 
oxygen,  hydrogen,  and  carbon,  consist  also  of  nitrogen,  and  are 


CONSTITUENTS  OF  THE  HUMAN  BODY.  19 

often  of  exactly  similar  composition,  although  very  different  in 
their  characters.  One  essential  distinction  is  in  regard  to  the 
existence  of  nitrogen,  upon  which  generally  depends  the  rapidity 
with  which  they  pass  into  a  state  of  decomposition  (become 
putrid). 

We  therefore  distinguish : 

6.  1.  Nitrogenized  Substances. 

1.  Protein  (discovered  by  Mulder),  [C40  H3,  N5  O12],  in  the  moist  state 
gelatinous;  dried,  brittle,  and  brownish;  is  scentless  and  tasteless,  insoluble  in 
water,  spirit  and  ether ;  soluble  in  all  dilute  acids,  and  forms  with  a  little  Sul- 
phur and  Phosphorus  the  following  (albuminous)  bodies. 

a.  Albumen;  [Pr10+P  SJ,  the  most  diffused  of  them,  is,  when  dried,  yel- 
lowish, brittle,  soluble  in  cold  water,  coagulable  by  heat,  creosote,  spirits  of 
wine,  and  unites  insolubly  with  nitric  and  tanuic  acid,  Plumb,  diacet,  alum, 
Corrosive  sublimate,  &c.     It  is  found  in  Lymph,  Chyle,  Serum  of  blood,  and 
especially  in  the  Brain. 

b.  Fibrin;  [Pr10  +  P  S],  readily  coagulates  (within  3 — 7  minutes),  is  fibrous, 
reteform;  is  present  in  a  soluble  condition  in  the  blood,  from  which  it  is  ob- 
tained by  whisking  it  with  twigs,  coagulated  in  the  muscles.     Vegetable  acids 
(and  their  salts)  and  caustic  alkalies  hinder  the  coagulation.     Coagulated  fibrin 
decomposes  super-oxyde  [Binoxyde]  of  Hydrogen  in  water,  not  albumen;  the 
latter  becomes  violet  with  Hydrochloric  acid,  the  former  indigo  blue. 

c.  Casein;  [Prj0  -}-  S],  soluble  in  water,  pale  yellow  in  solution,  coagulates 
(membranous  upon  milk)  by  boiling  (in  flakes),  by  Alcohol,  Acids  (particu- 
larly lactic),  and  rennet.     It  is  found  in  milk,  blood,  saliva,  bile,  and  pancreatic 
fluid,  lens. 

d.  Pepsin;  (discovered  by  Schwann)  [C48  H32  N8  O10  Vogel],  in  the  gastric 
juice,  in  the  parietes  of  the  gastric  glands,  and  upon  other  mucous  membranes; 
precipitates  by  acetate  of  lead,  dissolves  with  some  acid,  albumen  and  fibrin, 
very  readily  (digestion) ;  is  very  like  albumen ;  loses  by  coagulating  the  soluble 
property;  also  by  bile. 

e.  Globulin;  [Pr  15-f-  S],  that  is,  the  envelopes  and  nuclei  of  the  (microscopic) 
blood  corpuscles,  without  the  coloring  matter,  insoluble  in  Alcohol ;  very  like 
albumen.     Is  (according  to  Fr.  Simon)  Casein  united  with  Haematin. 

f.  Spermatin;  in  the  seminal  fluid,  is  probably  only  fibrin ;  is  soluble  in  water, 
becoming  a  clear  fluid,  which  does  not  coagulate  by  boiling. 

g.  Mucus;  consists  of  the  secretion  of  the  mucous  glands,  the  cast-ofF  epithe- 
lium of  mucous  membranes,  and  usually  also  of  pus ;  swells  up  in  water,  is 
soluble  in  strong  acids,  and  precipitated  by  tannin. 

h.  Peculiar  matter  of  tears;  dries  in  the  air  to  a  yellow,  insoluble  mucus ;  in 
acids  and  heat  not  coagulable. 

i.  Keratin;  [Pr  S2],  the  seemingly  homogeneous  matter  of  Epithelium,  Hair, 
Nails,  consists  of  different  substances,  like  e,  f,  g,  the  chemical  relations  of  which 
are  not  yet  singly  determined. 

[Nora.     There  are  great  doubts  as  to  the  existence  of  "Protein."] 

2.  Extractive  Matters. 

7-  Not  less  diffused  than  the  Protein  compounds,  is  the  animal  extractive 
matter,  which  is  particularly  obtained  from  muscular  substance  (flesh),  by 


20  GENERAL  ANATOMY. 

compression  and  inspissation,  and  hence  called  flesh  extract.  From  this  is 
again  obtained:  Water,  Spirit  (Osmazome),  and  Alcohol  extract,  according  as 
it  is  extracted  with  water,  spirit,  or  alcohol.  To  the  materials  soluble  in 
water,  merely,  belong  Ptyalin,  the  principle  of  saliva,  colorless,  scentless,  and 
tasteless,  soluble  in  water,  forming  a  slimy  fluid,  and  which  is  only  precipitated 
from  it  by  Alcohol.  It  is  found  only  in  Saliva,  which  changes  Starch  into 
Sugar,  and  Kreatin  (Chevreul). 

8.  3.  Matter  yielding  gelatin 

is  produced  by  long  boiling,  from  cartilages,  the  cartilaginous  basis  of  bones* 
from  the  membranes,  tendons,  and  ligaments,  and  from  the  cornea.  A  solu- 
tion of  gelatin  in  boiling  water  becomes,  upon  cooling,  a  jelly.  We  dis- 
tinguish the  proper  Gelatin  (colla)  [C52  H40  N8  02J,  which  is  obtained  from 
the  membranes,  tendons,  ligaments,  and  the  cartilaginous  basis  of  bone,  from 
the  Chondrin  [C32  H26  N4  014]  which  exists  in  the  cartilages  of  the  nose,  of 
the  ears,  the  ribs,  articular  cartilages,  and  the  cornea.  (Pyine,  the  basis  of  pus 
[Tritoxyd  of  Protein  C40  H31  N5  0,5  +  H  0],  is  said  to  be,  likewise,  a  gela- 
tinous substance.) 

9.  4.  Haematin,  [C*  H33  N3  06  Fe], 

the  colouring  principle  of  the  blood  which  is  contained  in  the  vesicles  of  the 
coloured  corpuscles  suspended  in  the  serum,  is  obtained  by  boiling  fresh  blood, 
and  evaporating  it  to  dryness ;  the  residue  is  then  boiled  with  ^Ether,  after- 
wards with  spirit,  when  the  red  matter  is  precipitated  in  flocculi.  In  a  pure 
state  brownish  black;  contains  Iron  (also  some  oxyde  of  manganese) ;  is  solu- 
ble in  alkalies.  [Haematin  may  be  obtained  free  from  iron,  as  a  red  Pigment 
C44  H22  N3  O6.j 

10.  5.  Principles  of  the  Bile.  (Berzelius.) 

a.  Bilin,  the  essential  principle  of  bile,  is,  in  a  pure  state,  when  dry,  colour- 
less, transparent,  not  crystallised,  bitter  to  the  taste,  easily  soluble  in  water, 
very  readily  metamorphosed;  is  decomposed  by  acids  into  Fellinic  and  Cho- 
linic  acids,  Taurin,  Dyslysin,  and  Ammonia.     Its  reaction  is  neither  alkaline 
nor  acid,  but  it  forms  with  acids  and  bases  easily  soluble  compounds. 

b.  Cholepyrrhiri  [bilipha?in,  Simon],  colouring  matter  of  bile,  is  sometimes 
found  as  yellow  powder  deposited  in  bile,  or  as  concretions  in  the  gall-bladder 
(gall  stones) ;  is  bright  reddish  yellow,  tasteless  and  scentless,  contains  nitrogen, 
colours  water  pale  yellow,  being  a  little  soluble  therein,  more  so  in  a  ley  of 
caustic  potash  or  Soda,  becomes  at  first  bluish  by  Nitric  acid,  then  green,  violet, 
red,  and  finally  yellow  or  yellowish  brown.     The  (green)  Biliverdin  is  a  pro- 
duct of  its  metamorphosis  by  acids. 

Mucus  from  the  biliary  passages  and  the  Gall-bladder,  causes  a  certain 
metamorphosis  of  the  bile,  is  precipitated  by  Alcohol  (also  acetic  acid). 

Bilifulvin,  the  yellow  colouring  matter  of  bile,  is  a  double  salt  of  lime  and 
of  soda  combined  with  an  [organic]  nitrogenous  acid. 

Extractive  matter,  Cholesterin,  oleate,  margarate,  and  stearate  of  soda,  with 
some  saponifiable  fat.  Chloride  Sodium,  sulphate,  phosphate,  and  lactate  of 
soda ;  phosphate  of  lime. 

[The  formulae  for  the  above  do  not  appear  to  be  accurately  determined.] 

11.  6.  Urea  and  Uric  Acid. 

a.  Urea  [C2  H4  N2  OJ,  in  the  urine  (with  lactic  acid);  in  ox  blood;  in  the 


CONSTITUENTS  OF  THE  HUMAN  BODY.  21 

blood,  in  disease,  and  in  other  fluids.  Produced  by  Nitric  acid,  and  again  libe- 
rated by  means  of  Carbonate  of  Baryta.  Composition :  corresponds  with  the 
cyanide  of  Ammonia  with  Water.  Artificially  formed  by  Wohler.  Colour- 
less, four-sided  prisms,  or  long,  silky,  shining  needles.  Spec.  grav.  =  1-35. 
Scentless,  it  produces  neither  acid  nor  alkaline  reaction ;  soluble  in  any  pro- 
portion in  boiling  water.  Unites  as  well  with  acids  as  with  bases. 

b.  Uric  Acid  [C10  H4  N4  O6],  in  the  urine  of  animals  feeding  on  flesh,  in 
urinary  calculi,  and  gouty  concretions.  United  with  ammonia  in  the  excre- 
ments of  birds  (Guano)  and  serpents.  Forms  a  light,  fine,  white  powder ; 
with  difficulty  soluble  in  water.  Is  precipitated  from  human  urine  upon 
cooling ;  at  first  grey,  men  pale,  rosy  red ;  or  by  the  addition  of  nitric  or  mu- 
riatic acids.  Uric  acid  easily  decomposes  urea,  upon  which  a  substance  re- 
mains behind  which  Liebig  calls  Uric.  Uric  is  one  of  the  most  feeble  acids ; 
its  salts  are  little  soluble  in  water.  -(Colouring  matter  of  urine,  an  extractive, 
mixed  with  salts,  is  reddish  brown,  saltish  bitter,  urinous  odour,  soluble  in 
water  and  alcohol,  is  of  an  amber  or  brownish  yellow,  easily  decomposes, 
decreases  when  living  on  vegetable  diet.) 

II.  Non-nitrogenized  Materials. 

12.  Sugar  of  milk,  lactic  acid,  fats. 

1.  Sugar  of  milk,  [Cg  H4  04  -f-  H  O]  saccharum  lactis.     f  of  the  solid  con- 
stituents of  human  milk  consist  of  sugar  of  milk.     It  may  be  procured  by 
evaporation  and  crystallization  from  whey,  that  is,  the  fluid  of  milk  deprived 
of  fat  and  casein.     It  forms  white  four-sided  prisms.     Spec.  grav.  =  1-543. 
Taste  slightly  sweet,  harder  man  cane  sugar,  easily  soluble  in  water ;  changes, 
in  time,  of  itself  into  lactic  acid,  as  well  as  by  rennet ;  by  yeast  it  passes  into 
grape  sugar  and  spirituous  fermentation. 

2.  Lactic  acid  acidum  lacticum.     [C6  H5  O-.J     In  all  fluids  and  secretions 
of  the  body,  freely  united  to  Potash,  fcoda,  Ammonia,  Lime,  and  Magnesia. 
Free  in  the  milk,  urine,  muscles,  and  sweat.     It  is  colourless  and  scentless, 
very  acid,  not  volatile  like  acetic  acid,  into  which  it  is  decomposed  by  strong 
heat ;  causes  albumen  and  casein  to  coagulate,  and  holds  phosphate  of  lime, 
the  principal  element  of  the  bones,  in  solution.     It  is  a  strong  acid,  separating 
acetic  acid  from  its  compounds.     Most  of  its  salts  are  soluble  in  water,  and 
crystallizable. 

3.  Fats  (Pingucdines)  are  insoluble  in  water,  in  hot  spirit  and  aether  they 
form  soluble  compounds  of  Carburetted   Hydrogen    with   a   little   oxygen. 
Most  of  them  become  metamorphosed  by  strong  bases,  especially  alkalies  and 
oxyde  of  lead,  into  soaps,  as  the  acid  contained  in  them  with  the  base  is 
transformed  into  a  salt.     We  therefore  distinguish  the  saponifiable  fats  from 
the  unsaponifiable  (Cholesterin  [C37  H32  O],  an  element  of  the  blood,  of  bile 
and  of  neurine,  frequently  present  in  gall  stones  and  other  pathological  secre- 
tions,— and  Serotin  discovered  by  Boudet  in  the  blood).     Fat  exists  free  in 
the  fibro-cellular  tissue  and  medulla  of  bones,  or  united  with  other  substances, 
as  for  example  in  the  milk,  the  brain,  the  hair,  the  cerumen  of  the  ear, 
pus,  &c. 

The  base  of  the  saponifiable  fats  of  the  human  body  is  Glycerin,  [C6  H7 
05.]  a  substance  separated  by  boiling  fat  with  oxyde  of  lead ;  the  acids  which 
unite  with  that  base  form  the  different  kinds  of  fat,  Stearic  (or  tallow)  [C68 
H66  °s  +  2  H  O]  and  Margaric  ['2  C34  H33  03  -f  H  O]  acids  on  the  one  side, 
and  Hair,  (oil)  [C44  H40  OJ  acid  on  the  other ;  lastly,  Butteric  [Cg  H7  03  -\- 
H  O]  and  Cerebric  acids. 


22  GENERAL  ANATOMY. 

The  solidity  of  different  fats  depends  upon  the  proportional  quantity  of  the 
above-mentioned  substances.  A  preponderance  of  Elain  renders  the  fat  fluid, 
such  as  oils ;  Margarin  constitutes  the  solid  element  of  lard,  whereof  human 
fat  is  an  example  j  Stearin  of  suet. 

II.  ELEMENTARY  FORMS  OF  THE  HUMAN  BODY. 
a.  Elementary  parts. 

13.  The  first  form  from  which  matter  is  developed,  and  which 
lies  as  the  basis  of  every  organic  structure  (vegetable  and  animal), 
is,  according  to  the  general  principle  first  enunciated  by  Schwann, 
1838,  the 

Nucleated  Cell,  that  is,  a  microscopical,  delicately  membranous  vesicle,  with 
fluid  contents  and  a  minute  dark  nucleus  (Cytoblast)  in  one  of  its  walls,  sur- 
rounded by  an  amorphous,  solid  or  fluid,  substance  (Cytoblastema  or  Inter- 
cellular substance),  out  of  which  the  nucleated  cell  forms  itself. 

The  nucleus  is  round  or  oval,  rather  flattened,  yellowish  red,  smooth  or 
granular,  has  a  diameter  of  0'002 — (H)04'"  and  probably  first  arises,  as  the 
granules  are  deposited  from  the  amorphous  mass  about  a  central  point,  are 
circumscribed  and  blend  together.  About  the  nucleus  formed  from  the  mass 
a  membrane  is  generated,  the  vesicle  of  the  cell  [cell  membrane]. 

14.  This  process  of  development  may  at  least  be  observed  in 
the  egg  [germ]  of  vegetables  and  animals,  in  the  formation  and 
reproduction  of  certain  tissues  (for  example,  the  nails  and  cuticle). 
Also  in  the  blood,  in  pus,  and  in  milk,  the  process  is  essentially 
the   same.     The   formation  of  the  elementary  granules  may  be 
compared  with  the  physical  phenomenon,  discovered  by  Ascher- 
son,  namely,  that  when  albumen  was  brought  into  contact  with 
fat  (oil  drops)  it  coagulated  in  the  form  of  a  membrane,  and 
enveloped  them.     But  the  vital  and  self-dependent  progressive 
development  of  the  nucleated  cell  is  in  no  degree  explained  by 
this. 

15.  Increase  of  the   Cells.     The  number  of  the    cells  in  a 
tissue  in  the   process   of  development,  increases  either  by  the 
origin  of  single  new  ones  independent  of  one  another  (e.  g.,  in  the 
hair,  nails,  inflammatory  exudation) ;  or  by  the  development,  in 
the  interior  of  the  old  and  mature,  of  new  secondary  cells,  to 
which   the  contents   of  the  primary  cell  serve  as  cytoblastema. 
(Thus,  in   the    development   of  the  liver,  and  in   pathological 
growths;  e.  g.,  Scirrhous.) 

16.  Metamorphosis  of  Cells.     As  the  cells  pass  through  vari- 
ous stages   of  development,  they  also  present  different  circum- 
stances in  respect  to  their  shape,  position,  contents,  and  chemical 
relations.     In  some  tissues  they  maintain  their  independence,  at 
most  lying  upon  one  another,  and  becoming  thereby  flattened,  or 


ELEMENTARY  FORMS.  23 

elongated  and  pointed  (e.  g.,  in  the  granular  pigment,  in  the  blood, 
in  the  muscular  tunic  of  the  intestines).  Others  attain  a  size  of 
more  importance  (fat  cells),  or  diminish  in  size  (the  lymph  glob- 
ules, if  they  become  changed  into  blood  corpuscles) ;  they  lose 
after  a  time  their  nucleus  (the  mature  blood  corpuscles);  their 
parietes  become  thickened  (cartilage  cells). 

17.  In  most  tissues  the  cells  blend  together  and  coalesce.     We 
find  remaining, 

1.  The  cavities  of  the  cells  unaltered,  as  their  thickened   walls  blended 
together  (in  true  cartilage,  and  osseous  tissue), or  the  parietes  impinging  upon 
one  another  are  broken  through,  so  that  continuous  tubes  arise   (renal  and 
seminal  tubuli,  perhaps  also  capillaries) ;  or, 

2.  The  cavities  disappearing,  their  parietes  lying  flat  together,  so  that  the 
cells  form  solid  laminae,  which  appear  to  be  spread  out  either  in  a  mem- 
branous or  fibrous  form,  according  to  the  position. 

Here  belongs  also  the  coalescing  of  complex  (endogenous)  cells  [see 
before],  which  are  transformed  into  the  primitive  fibres  of  the  nerves,  and 
the  primitive  bundles  of  the  animal  muscular  tissue. 

3.  The  nuclei  of  the  cells  elongate,  coalesce,  and  thus  form  the  "  nucleus 
fibres,"  which,  much  stronger  than  the  cell  fibres,  upon  which  they  are  found, 
are  distinguished  from  them,  also,  by  their  insolubility  in  acetic  acid.     They 
are  either  rectilinear,  spiral,  or  like  a  tendril,  according  to  the  position  of  the 
nucleus  in  the  cell. 

18.  As  the  cells  are  dislodged  from  their  situation,  or  become 
again  formed  into  the  homogeneous  mass  of  cytoblastema  out  of 
which  they  arose,  intervals  are  formed  which  are  filled  with  fluids 
or  air ;  these  are  the  intercellular  passages.     They  are  circum- 
scribed by  layers  of  cells,  and  appear,  after  the  metamorphosis  of 
the  cells  into  fibres,  as  canals  and  cavities  (closed  and  open  vascu- 
lar cavities,  lined  with  mucous  membrane),  with  membranous  or 
fleshy  parietes.     It  is,  moreover,  a  matter  of  indifference  whether 
the  structureless  matter  which  also  serves  as  a  uniting  medium  be 
solid,  as  in  the  bones,  or  fluid,  as  in  the  blood.     The  conditions 
for  the  formation  of  proper  tissues  are  given  with  the  metamor- 
phoses of  the  cells  and  nuclei ;  in  a  system  of  Histologia  these 
must  also  be  received  as  a  basis,  and  not  that,  more  or  less  com- 
posed of  organs,  as  in  the  earlier  systems.     As   however  the 
number  of  facts  is  yet  too  small  for  the  complete  carrying  out  of 
a  scientific  arrangement,  we  must  for  the  present  observe  a  greater 
number  of  casual  successions.     In  this  point  of  view,  therefore, 
anatomy  can  lay  no  claim  to  the  name  of  a  science. 

b.  Individual  tissues. 

19.  External  membrane,  Epithelium. 

The  non-vascular  and  nerveless  thin  investment  which  covers 


24  GENERAL  ANATOMY. 

all  the  surfaces  of  the  body,  the  external  skin,  as  well  as  the  in- 
terior of  cavities  and  canals,  is  called  Epithelium.  (Formerly 
this  term  comprehended  the  covering  of  the  mucous  membrane 
only.) 

It  consists  of  a  layer  of  independent  nucleated  cells,  formed  from  the  or- 
ganic matter,  which  the  highly  vascular  surface  (matrix)  lying  immediately 
underneath  it,  deposits,  and  which  increases  layer  by  layer. 

20.  It  does  not  merely  serve  as  a  defence  to  the  tunic  upon 
which  it  exists,  but  also  for  the  reception  and  secretion  of  certain 
substances.  Wounding  it  gives  rise  to  neither  pain  nor  bleeding. 

According  to  the  Elementary  parts,  three  kinds  are  distinguished.     (Henle.) 

a.  Pavement  epithelium.     Cells  and  nuclei  roundish,  oval,  or  where  lying 
close  to  one  another,  multangular,  and  conjoined   like  mosaic.     This  most 
frequent  variety  forms  thick  layers,  and  is  found  upon  the  internal  surface  of 
serous  membranes,  of  the  vascular  system,  upon  the  mucous  membrane  of 
the  mouth,  the  nose,  or  the  globe  of  the  eye.     Upon  the  cornea  of  the  eye  it 
soon  becomes  dull  after  death,  and  appears  as  a  white  mucus,  whence  the 
dull  appearance  of  the  dead  eye  arises.     The  salivary  mucus,  also,  consists 
in  great  part  of  this  kind. 

To  this  belongs  also  the  Epidermis.     See  external  skin. 

b.  Cylinder  epithelium.     Cells  of  a  cylindrical  or  conical  shape,  the  point 
of  which  is  directed  towards  the  mucous  membrane,  arranged  like  fibres. 
Nucleus  generally  between  the  base  and  apex  of  the  cone. 

They  are  present  in  man  upon  the  mucous  membranes  only.  In  the  ali- 
mentary canal  they  commence  at  the  mouth  of  the  stomach  (Cardia),  and  ter- 
minate at  the  anus ;  being  most  distinct  in  the  cylindrical  glands  of  the  large 
intestines.  Upon  the  mucous  membrane  of  the  male  organs  of  generation ; 
at  the  opening  of  the  salivary  glands.  In  the  gall-bladder  they  appear 
coloured  green. 

c.  Ciliated  epithelium  is  distinguished  from  the  cylindrical  simply  in  the 
fact  of  its  possessing  ciliae  at  one  of  its  extremities.     The  ciliae  themselves 
are  variously  formed.     Longitudinal  diam.  of  cell=  0'015  of  a  line,  the  ciliae 
=  0-0018  of  a  line. 

They  exist  in  man  upon  the  mucous  membrane  of  the  respiratory  organs, 
the  eyelids,  the  female  organs  of  generation,  and  upon  the  parietes  of  the 
cerebral  ventricles.  It  is  obtained  most  readily  from  the  nasal  mucous  mem- 
brane. 

Ciliary  motion.  According  to  Purkinje  and  Valentin,  the  discoverers,  it  is 
of  three  kinds : — 

1.  The  ciliae  more  in  the  shape  of  an  inverted  cone,  since  their  apices  de- 
scribe a  wider  circle  than  their  bases. 

2.  The  whole  cilium  moves  in  an  undulating  manner. 

3.  The  apex  curves  like  a  hook. 

A  low  temperature  (-}-  5°  R.),  acetic,  strong  mineral  acids  and  bile  arrest 
the  ciliary  motion.  The  stream  of  the  fluid  in  which  the  ciliae  move  is  op- 
posed to  the  direction  in  which  they  curve,  and  generally  passes  from  within 
to  without. 

The  object  of  the  ciliary  movements  is  not  yet  ascertained.  In  diseases, 
for  example,  catarrh,  the  ciliary  epithelium  is  at  first  thrown  ofil 


ELEMENTARY  FORMS.  25 

21.  Nails,  Ungues, 

are  four-sided  transparent  plates  of  horn,  rounded  from  before  to 
behind,  and  from  side  to  side,  which  are  placed  upon  the  dorsal 
surface  of  the  last  phalanx  of  the  fingers  and  toes.  They  lie 
with  their  lateral  edges  in  a  fold  of  the  corium.  In  the  same 
manner  the  posterior  border,  the  root,  the  length  of  which  con- 
tributes one-fifth  to  one-sixth  the  length  of  the  entire  nail.  The 
root  extends  about  two  lines  deep  into  the  fold,  and  is  likewise 
surrounded  above  and  below  by  the  corium.  The  remaining 
portion,  the  body  of  the  nail,  is  only  united  on  the  inferior  surface 
with  the  corium ;  its  anterior  edge,  the  point  of  the  nail,  quite  free. 

22.  The  epidermis  turns  up  at  the  root  of  the  nail  towards 
the  fold  of  skin,  without  going  deeper  into  it.     By  scalding  the 
epidermis  is  loosened  from  the  corium,  and  the  nail  with  it. 

23.  The  bed  of  the  nail,  matrix  unguis,  is  the  fold  before 
mentioned,  and  the  surface  of  the  cutis  which  is  covered  by  the 
nail.     It  determines  the  shape  of  the  nail;  is  smooth  above,  below 
striated  like  the  cutis.     The  striae  consist  of  elevated  ridges  which 
pass  from  before  to  behind,  and  upon  which  are  placed  cylindrical 
papillae.     The  striae  become  stronger  towards   the  point  of  the 
nail  and  appear  through,  but  the  nail  itself  does  not  consist  of 
parallel  longitudinal  fibres.     Anteriorly  the  matrix  is  richer  in 
vessels  than  at  the  root  of  the  nail,  where  even  a  whitish  semi- 
lunar  mark  (lunula)  appears,  whilst  the  rest  of  the  nail  is  pale  red. 

The  tissue  of  the  nails  is  only  distinguished  from  that  of  the  Epidermis  by 
its  hardness  and  brittleness,  which  depends  upon  Phosphate  of  Lime  (Lauth). 
It  consists  of  flat,  dry,  non-nucleated  cells,  which,  deposited  in  layers  and 
spread  out  like  a  membrane,  form  plates,  which  run  longitudinally.  Cor- 
responding to  the  Rete  Malpighi  of  the  Epidermis,  we  may  here  also  remark 
a  soft  and  white  layer,  particularly  in  young  children.  In  old  people  in- 
dented, undulating  transverse  striae  appear  upon  the  nails,  particularly  of  the 
toes. 

The  nails  are  first  distinguishable  in  the  fifth  month  of  foetal  life  by  their 
firmness,  but  even  in  the  third  month  the  fold  fixes  their  limits. 

The  growth  of  the  nail  takes  place  from  the  matrix,  and  the  old  parts  are 
pushed  forwards  by  the  younger,  from  the  roots.  They  may  reach  the  length 
of  two  inches.  In  many  diseases  (e.  g.,  Typhus)  they  fall  out,  in  others  (as 
Phthisis  pulmonalis,  Plica  Polonica)  they  become  thickened  and  curved.  After 
falling  out.  the  surface  of  the  matrix  becomes  covered  with  a  thin  horny  layer, 
which  is  always  more  thickened  over  the  recess  of  the  lunula. 

24.  Granular  Pigment, 

improperly  denominated  black  pigment,  is,  like  the  preceding,  a 
nerveless  and  non-vascular  tissue,  for  which  the  highly  vascular 
membranes  upon  which  it  appears  serve  as  a  matrix. 


26  GENERAL  ANATOMY. 

25.  It  exists  to  the  greatest  extent  among  the  coloured  races, 
especially  negroes,  the  entire  surface  of  whose  bodies  is  covered 
with  it.     It  here  lies  between  the  cutis  and  rete  Malp.  of  the 
epidermis.     It  is  not  black,  but  dark  brown,  and  thus  gradually 
proceeds  even  into  yellowish.     Among  the  Caucasian  tribes  it  is 
especially  found  in  the  eye  on  the  posterior  surface  of  the  iris. 
Moreover,  also  in  the  healthy  state  about  the  female  nipple,  on 
the  skin  of  the  scrotum,  of  the  great  labia,  and  of  the  anus,  in  the 
Bronchial  glands;  in  pathological  conditions,  as  Freckles,  and  in 
scirrhous  growths. 

The  pigment  tissue  consists  of  globular,  multangular,  or  tubular,  elongated 
cells  (pigment  cells)  in  which  the  coloured  particles  lie  (pigment  corpuscles). 
The  pigment  from  the  internal  surface  of  the  Choroid  coat  of  the  globe  of  the 
eye  is  the  best  for  examination. 

The  cells  are  destroyed  by  putrefaction,  and  are  soluble  in  acetic  acid ; 
the  pigment  granules  pass  out,  as  extremely  small,  flat  points,  which,  only 
when  they  are  heaped  together,  present  a  yellowish  red  and  brownish  ap- 
pearance. They  are  only  soluble  in  caustic  Potash,  and  become  changed  in 
colour  by  Chlorine. 

The  ashes  of  the  Pigment  consist  of  muriate  of  soda,  lime,  phosphate  of 
lime,  and  oxide  of  iron.  The  purpose  fulfilled  by  the  Pigment  in  the  skin 
cannot  be  decided;  in  the  eye  it  serves  to  protect  it  from  too  strong  light. 
Pigment  is  wanting  in  the  eyes  as  well  as  in  the  hair  of  Albinos. 

26.  Hairs,  Pili  s.  Crines, 

are  thin,  hard,  elastic,  and  thread-like  cylinders  of  various  colours. 
Non-vascular  and  without  nerves  like  the  foregoing  tissues,  they 
must,  however,  on  account  of  their  more  complicated  structure, 
be  considered  as  more  highly  organised.  They  are  also  nourished 
by  a  highly  vascular  basis,  which  is  regarded  as  an  inversion  of 
the  cutis. 

The  whole  external  surface  of  the  body  is  covered  with  larger 
or  smaller  hairs,  with  the  exception  of  the  palms  of  the  hand,  the 
sole  of  the  foot,  the  lips,  the  superior  eyelid,  the  foreskin,  Glans 
penis,  and  Clitoris. 

Structure.  The  roots  of  the  hair  lie  deeply  in  the  cutis,  sur- 
rounded by  the  hair  follicle,  and  seated  with  the  soft  club-shaped 
bulb  upon  the  germ  of  the  hair  (Pulpa).  The  body  or  shaft  of 
the  hair  projects  beyond  the  surface  of  the  body,  and  terminates 
in  a  free  point. 

In  the  shaft  two  substances  are  distinguished : — 

a.  The   Cortex,  is  transparent  and  smooth,  striated  longitudinally,  fibrous, 
especially  towards  the  roots.     The  transverse  strirp,  which  are  observed  upon 
it,  consist  of  encircling  scales,  which  may  be  detached  by  the  action  of 
Sulphuric  Acid. 

b.  The    medullary  substance  is  wanting  at  certain   points   in   coarse,  and 
sometimes  altogether  in  fine  hair.     It  consists  of  small  globules,  resembling 
fat  drops,  is  dark,  and  never  found  in  the  point  of  the  hair.     Diameter 


ELEMENTARY  FORMS.  27 

=  0-017  of  a  line.  The  length,  thickness,  and  shape  of  the  shaft  vary 
considerably  with  individuals  and  in  different  parts  of  the  body.  The  free 
extremity  is  frequently  split. 

The  hairs  of  the  head  are  generally  cylindrical,  frequently  also  flat  and 
very  curly  (woolly  hah:  of  Negroes). 

The  beard  and  pubic  hairs,  those  of  the  axillary  fossa,  of  the  eyebrows,  the 
entrance  to  the  nose  and  the  ears,  are  oval  (upon  transverse  section). 

The  root  of  the  hair,  bulb  (head  of  the  hair  according  to  Henle),  bulbus 
pili,  is  soft,  viscous  1 — 2  lines  long,  below  thick  and  hollow,  containing  a 
tenacious  substance,  in  which  cell  nuclei  lie  (as  in  the  rete  Malp.) ;  farther 
upwards,  surrounded  by  transverse  fibres,  which  connect  firmly  together  the 
longitudinal  fibres ;  the  superior  extremity  is  uninterruptedly  connected  with 
the  shaft  of  the  hair.  The  Medulla  by  degrees  loses  itself  below. 

Outside  the  shaft  of  the  hair  the  sheath  of  the  root  passes  from  the  bulb, 
which  immediately  continues  into  the  Epidermis,  of  which  it  is  only  an  in- 
version, just  as 

The  Hair  follicle  (folliculus  pili)  is  an  inversion  of  the  Corium.  This 
consists  of  fibres  of  areolar  tissue,  and  terminates  blindly,  with  a  process 
above  (Pulpa),  upon  which  the  hair  bulb  is  seated.  It  possesses  nerves  and 
vessels,  pain  and  blood,  therefore,  on  wounding.  Into  it  open  the  smallest 
sebaceous  (gland  of  the  hair  follicle)  glands.  (See,  under  Cutis.) 

Characters.  Hairs  become  electrical  by  rubbing,  and  attract  moisture  both 
from  the  air  and  body.  They  are  therefore  soft  and  shining  in  perspirable, 
and  brittle  in  dry  skins. 

Chemical.  Hair  consists  of  fat  and  Keratose  substance,  the  former  pro- 
bably coming  from  the  medulla,  the  latter  from  the  cortex.  Boiling  alcohol 
draws  out  the  fat  containing  the  colouring  matter,  Elaine.  It  is  acid;  red 
in  red,  and  greyish  green  in  dark  hair.  Nitric  acid  dissolves  the  hair,  chlorine 
bleaches  and  makes  it  glutinous.  In  the  ash  we  find  some  oxide  of  iron, 
oxide  of  manganese,  and  silex,  together  with  sulphate,  phosphate,  and  car- 
bonate of  lime. 

Growth.  Hairs  grow  out  of  the  highly  vascular  follicle,  and  are  renewed, 
like  the  nails,  by  deposits  from  below.  The  cut  off  point  is  not  again  re- 
stored, but  the  piece  immediately  next  to  it  is  pushed  from  below  forwards; 
the  point  is  also  the  first  part  generated.  The  first  development  appears 
after  the  third  month  of  foetal  life;  even  before  birth  the  entire  body  is 
covered  with  woolly  hair  (lanugo),  which  at  a  later  period  falls  off. 

With  puberty  the  beard  and  pubic  hairs  are  developed,  the  hair  in  the 
axilla,  glandebalte,  and  on  the  chest. 

NOTE.  The  skin  of  the  head  produces  most  hair  (=  293  on  ^  a  line  square), 
more  fair  than  brown,  and  more  brown  than  black.  The  hair  follicles  gene- 
rally lie  in  twos  and  threes  in  regular  lines,  for  which  a  fixed  point,  e.  g.,  the 
crown  of  the  head,  serves  as  a  centre. 

In  old  age  the  roots  of  the  hair  become  knotty;  the  shaft,  from  deficiency 
of  oil,  grey ;  and  the  hair  falls  off.  White  hair  is  also  found  on  Albinos. 

NOTE.  Hair  is  sometimes  found  abnormally  upon  the  mucous  membrane 
of  the  eye,  in  the  gall  bladder,  in  the  ovaries  [and  in  the  thorax.  Prepara- 
tion shown  to  me  by  Dr.  Munk.  TKAXS.] 

27.  To  the  so-called  non-organised  tissues,  the  laminated  structures 
(Burdach).  belong  the  Cornea  arid  crystalline  lens  of  the  eye.  (To  which 
refer.)  Nearest  to  these  we  may  comprehend  : 

23.  The  uniting  tissue  (J.  Muller)  cellular,  areolar  or  fibro-cellular,  a 
sort  humid  mass,  penetrated  by  vessels  and  nerves,  which  is  diffused  every- 


28  GENERAL  ANATOMY. 

where  throughout  the  body,  serving  partly  as  a  uniting,  partly  as  an  envelop- 
ing medium  for  the  organs  and  their  elements.  It  possesses  a  fibrous  inter- 
lacement, is  very  elastic  and  translucent,  and  by  boiling  is  metamorphosed 
into  Gelatin  (?). 

Structure.  Uniting  tissue  consists  of  long  and  probably  solid  fibres,  which, 
held  together  by  amorphous  blastema,  and  generally  united  into  white  bundles, 
become  transparent  by  acetic  acid.  Dark  spiral  filaments,  which  are  not  made 
transparent  by  acetic  acid,  wind  themselves  in  a  serpentine  arrangement  about 
each  bundle,  and  are  probably  developed  from  nucleus  fibres,  just  as  those 
of  the  first  from  fibres  of  the  cell  vesicle. 

29.  We  distinguish  two  kinds  of  uniting  tissue  : 

1.  Amorphous.     It  is  loose  and  fills  up  the  intervals  between  the  organs 
and  their  parts,  for  example,  between  the  lobes  and  lobules  of  the  liver ;  it 
lies  in  great  masses  under  the  Cutis,  and  forms  cells,  in  which  air  and  fluid 
may  collect,  or  in  which  fat  vesicles  are  deposited.     Vessels  and   nerves 
traverse  it  in  larger  or  smaller  numbers.     Burdach  calls  the  uniting  tissue 
which  envelopes  the  exterior  of  organs  atmospherical  (thus  the  subcutaneous 
areolar  tissue),  and  that  which  enters  into  the  organ  parenchymatous. 

2.  Figurate.     It  forms  membranes,  bladders,  cords,  and  discs ;  is  fibrous, 
and  the  more  even  and  brilliant  the  thicker  its  tissue.     Of  it  we  may  dis- 
tinguish two  kinds : 

a.  Not  contractile,  uniting  tissue  (fibrous  or  tendinous). 

1.  Tendons.     They  are  very  dense  and    strong,  little    elastic,   and   long 
resist   decomposition    and    chemical    influences;    they   contain   0'62    water. 
Where  tendons  pass  over  bones,  a  loose  uniting  tissue  with  coarse  meshes 
surrounds  them  (Synovial  sheaths),  in  which  a  glairy  clear  fluid  is  contained 
(Synovia). — The  tendons  (sinews)  are  adherent  to  the  muscular  fibres,  irom 
which  they  are  only  prolonged,  and  to  which  they  are  firmly  attached  by 
uniting  tissue. 

2.  Ligaments,  ligamenta,  are  quite  similar    to  tendons,  but  generally  flat. 
To  this  class  belongs  the  round  ligament  (Jig.  teres),  which  assists  in  main- 
taining the  head  of  the  femur  in  the  acetabulum ;  the  membrana  obturat.  of 
the  thyroid  or  oval  foramen  of  the  oss  innominatum  and  the  memb.  interrossea 
form  a  transition  towards  the  fibrous  membranes.     The  elastic  and  inter- 
articular  ligaments  of  the  vertebral  column  do  not  belong  to  this  class.     (See 
Syndesmology). 

3.  Ligamentary    discs.      [Interarticular    cartilages,    Glenoicl    ligaments.] 
Very  strong,  and  therefore  formerly  enumerated  with  the  cartilages  which, 
moreover,  are  less  elastic.     They  are  intended    to  prevent  the  pressure  of 
two  cartilaginous  surfaces  upon  one  another,  on  which  account  they  are  also 
invested  with  Synovial  sheaths.     Tendinous  fibres,  which  pass  off  from  the 
borders,  are  attached  to  the  articular  capsules  or  cartilages. 

Ligamentary  Discs  are  found  in  the  articulations  of  the  jaw  and  knee ;  in 
the  superior  eyelid  (tarsus,  the  so-called  cartilage),  around  the  articular  fossae 
of  the  acetabulum  and  scapula  (labra  cartilaginea). 

4.  Fibrous  membranes.     To  this  class  belong: 

The  external  coverings  or  case  of  many  viscera,  serving  as  a  defence  for 
the  Parenchyma,  or  for  the  attachment  of  muscles,  e.  g.,  the  Sclerotica  of  the 
eye,  the  jHbuginea  of  the  testis,  Dura  Mater  of  Brain  and  Spinal  cord,  the 
covering  of  the  pericardium,  of  the  kidneys,  ovaries,  spleen,  clitoris,  and 
urethra. 

The  tendons  of  the  muscles  attached  are  interwoven  with  them.  Their 
tissue  consists  of  separate  fibres,  or  of  more  or  less  interlaced  bundles.  They 
are  covered  with  epithelium. 


ELEMENTARY  FORMS.  29 

The  tendinous  expansion  of  the  Diaphragm. 

The  membrana  tympani. 

The  valves  in  the  heart,  the  veins,  and  in  the  lymphatics. 

The  neurilemma,  that  is,  the  envelope  which  surrounds  the  nerves. 

The  fasciae.  They  are  developed  from  the  amorphous  layers  of  uniting 
tissue  like  membranes,  and  envelope  the  muscles  passing  into  the  intermus- 
cular  ligaments,  and  from  these  into  the  periosteum  (ligament.  Cruriata),  or 
into  the  tendons  of  muscles  (fasc.  rect.  abdomin.") 

Periosteum  (membrane  covering  the  bones),  and  Perichondrium  (that  cover- 
ing the  cartilages).  They  surround  the  bones  and  cartilages  externally,  and 
are  attached  to  these,  from  the  first,  by  the  extremely  numerous  vessels 
connected  together  by  areolar  tissue,  of  which  they  consist  In  the  cavity  of 
the  bones  the  periosteum  is  with  difficulty  separated  from  the  epithelium 
lying  upon  it 

5.  Tunica  propria  of  the  intestinal  canal,  of  the  gall  and  urinary  bladders, 
the  pelvis  of  the  kidneys,  the  ureters,  &c.,  is  a  peculiar  membrane  (T.  nervea, 
vasculosa)  of  uniting  tissue,  which  lies  between  the  muscular  layer  and  mu- 
cous membrane ;  shining  white ;  almost  inseparably  connected,  externally, 
with  the  uniting  tissue  of  the  muscles  ;  internally,  with  that  of  the  mucous 
membrane. 

6.  Serous  membranes.     They  serve  as  the  boundaries  of  cavities  inside 
the  body,  and  are  generally  quite  closed.    Henle  makes  a  distinction  between 
true,  that  is,  such  as  are  covered  on  the  outside  with  (pavement)  epithelium, 
and  false,  in  which  it  is  wanting. 

To  the  false  belong  the  Bursts  Mucosa  of  muscles,  tendons,  and  mem- 
branes ;  these  are  closed  sacs,  filled  with  watery  or  viscous  fluid,  which  lie 
between  muscles  and  bones  (capsula  synoviales). 

The  true  serous  membranes  consist  of  a  layer  of  Epithelium  (generally 
pavement,  only  in  the  tubes  of  the  Uterus  ciliated),  and  of  fibrous  uniting 
tissue,  which  approaches  at  one  time  fibrous,  at  another  time  elastic  tissue. 
The  separation  of  the  subserous  uniting  tissue  is,  almost  in  all  cases,  only 
artificial. 

They  not  only  serve  for  lining  cavities,  but  also  as  the  envelopes  of  the 
organs  which  lie  in  them.  But  it  is  not  essential  that  they  should  be,  every- 
where, entirely  closed.  (The  peritoneum  of  the  female  is  open  at  the  extre- 
mities of  the  Fallopian  tubes.) 

To  this  class  belong:  Plura  and  Peritoneum,  Pericardium,  Arachnoidea, 
Tunica  Vaginalis.  They  lie  in  the  cavities  as  sacs,  the  external  surface  of 
which  is  attached  by  plain  uniting  tissue,  partly  to  the  walls  of  the  cavities, 
partly  passing  over  upon  the  organs,  which  forms  a  sort  of  inversion  of  it ; 
the  internal  surface  is  smooth,  covered  with  pavement  epithelium,  and  se- 
cretes a  thin,  watery,  albuminous  fluid.  Serum. 

The  sacs  form  folds,  ligaments,  and  rete,  particularly  at  the  places  where 
the  vessels  and  nerves  are  allowed  a  free  thoroughfare  to  the  organs  enveloped 
by  them.  The  vessels  and  nerves  become,  therefore,  covered  by  uniting  tissue 
and  epithelium,  but  they  do  not  perforate  the  serous  sacs. 

The  serous  membranes  do  not  pass  merely  into  fibrous,  but  also  into  mucous 
membranes  (e.  g.,  mucous  membrane  of  the  tympanic  cavity). 

7.  The  vascular  membrane  of  the  brain  (Pia  Mater),  and  that  of  the  eye 
(Choroidea),  that  is,  a  membranous  uniting  tissue  as  a  support  for   vessels 
which  nourish  another  organ.     Pia  Mater,  like  periosteum,  is  firmly  connected 
with  the  brain,  into  which  its  vessels  penetrate,  and  consists  of  loose  bundles. 
Choroidea  resembles  the  Corium,  which  serves  as  a  Matrix  for  the  Epidermis. 


30  GENERAL  ANATOMY. 

It  is  dense,  strong,  and  smooth,  and  only  made  adhesive  by  the  black  Pigment 
which  it  deposits. 

Vessels  and  nerves  of  figurate,  non-contractile  uniting  tissue.  Vessels  which 
not  only  go  through,  but  belong  to  the  uniting  tissue  itself,  are  found  in  small 
numbers  in  the  strong  structures  (tendons,  fibrous  membranes) ;  in  larger  in 
the  serous,  the  proper,  and  vascular  membranes.  Moreover,  the  quantity  of 
the  vessels  in  one  and  the  same  membrane  differs  according  to  position  (e.  g., 
the  synovial  membrane  is  more  highly  vascular  at  that  part  where  it  covers 
the  fibrous  articular  capsule,  than  upon  the  cartilage). 

Nerves  are  not  found  in  the  tendons  (therefore  they  are  not  sensitive); 
such  as  are  found  in  the  fibrous  membranes  do  not  probably  terminate  in 
then:  substance.  Whether  nerves  passing  to  serous  membranes  remain  in 
them,  is  also  still  doubtful,  although  it  is  a  fact  that  peritonitis  or  pleuritis  is 
very  painful. 

b.  Contractile  uniting  tissue,  that  is,  such  as  contracts  upon  irritation.  To 
this  class  belong : 

1.  The  external  skin,  Cutis  and  Corium  (which  see). 

2.  Tunica  dartos   (see  Splanchnol.),  the  wrinkled,  reddish  membrane  on 
the  posterior  surface  of  the  Scrotum,  of  fibrous  tissue,  which  consists  of  a 
network  of  longer  meshes,  since  the  longitudinal  bundles  of  uniting  tissue 
anastomose.     (Septum  Scroti  consists  of  fibrous  and  common  uniting  tissue.) 
It  is  remarkable  for  its  vascularity  and  contractility,  without  muscular  fibres. 

3.  The  tissue  of  the   Corpora   Cavernosa,  of  the  penis  and  Clitoris,  of  the 
corpus  Spongiosum  urethra,  consists  of  a  dense  network  of  very  extensible,  but 
strong,  flattened,  or  roundish  bundles  of  uniting  tissue      A  fibrous  sheath 
envelopes  and  separates  the  two  cavernous  bodies.  From  it  (tunica  JllbugineiC) 
larger  or  smaller  laminae  and  septa  extend  inwards  into  the  above-mentioned 
network :  each  lamina  is  provided  with  a  blood-vessel. 

4.  The  contractile  tissue  of  the  longitudinal  and  circular  fibrous  coat  of  the 
veins  and  lymphatics  (which  see). 

The  movement  of  the  contractile  tissues  is  not  the  consequence  of  a  merely 
physical  elasticity.  The  external  skin,  when  it  contracts,  becomes  thickened, 
shortened,  and  sinks  in ;  the  openings  of  the  hair  follicles  therefore  pass  out 
(goose-skin),  the  hair  stands  on  end.  The  same  with  the  nipple. 

The  Scrotal  skin  lies  in  transverse  folds,  when  the  longitudinal  fibres  of 
Tunica  Dartos  contract. 

The  Penis  shrinks  up,  becomes  harder  and  firmer,  and  the  blood  retires, 
when  the  cavernous  tissue  contracts. 

The  development  of  uniting  tissue  takes  place  from  nucleated 
cells,  as  may  be  demonstrated,  which,  according  to  Schwann,  be- 
come pointed  in  two  opposite  directions,  and  in  this  manner  form 
spindle-shaped  fibres,  from  which  finer  ramifications  pass  of. 

Uniting  tissue  is  very  readily  regenerated ;  its  lost  substance  is 
replaced  by  a  scar  (cicatrix),  which  in  loose  parts  is  more  firm, 
in  tendinous  less  so. 

The  fluid  (serum)  which  we  find  in  uniting  tissue,  is  no  secreted 
product  from  it,  but  is  the  fluid  of  the  blood  which  penetrates  the 
parietes  of  the  vessels  therein,  and  so  much  the  sooner  collects 
together  the  looser  it  is  (e.  g.,  in  dropsy  of  the  scrotum,  about  the 
ankles,  &c.) 


ELEMENTARY  FORMS.  31 

111  like  manner,  the  fat  is  still  less  a  secretion  of  the  uniting, 
but,  a  proper  tissue. 

30.  The  Adipose  Tissue, 

has  only  of  late  been  recognized  as  an  independent  tissue,  par- 
ticularly by  Gurlt,  whilst  formerly,  misled  by  the  appearance  of 
the  fat  vesicles  in  the  cellular  interspaces  of  the  uniting  tissue, 
we  were  accustomed  to  regard  the  latter  as  the  organ  for  the 
secretion  of  the  fat.  But  even  the  divided  portions  of  fat,  sur- 
rounded by  uniting  tissue,  have  their  own  proper  cells  separated 
from  it. 

Distribution.  The  fat  tissue  appears  connected  together  like  a 
membrane,  especially  in  the  uniting  tissue  under  the  corium,  as 
the  most  inferior  layer  of  which  (fat  membrane,  Panniculus  adi- 
posus]  it  is  considered ;  more  abundant  in  children  and  women 
than  in  the  aged  and  men ;  in  greatest  quantity  under  the  sole  of 
the  foot  and  on  the  mammary  gland.  Less  perfectly  formed  and 
more  collected  together  in  masses  it  presents  itself  in  the  orbits, 
and  as  marrow  in  the  medullary  cavities  of  the  cylindrical  bones. 
Accumulated  immoderately  in  all  the  usual  places,  general  corpu- 
lency results ;  in  separate  or  uncommon  regions  it  is  present,  as 
lipoma  (fatty  tumour). 

Structure.  The  fat  tissue  consists  of  cells,  in  which  a  dropping  fluid,  the 
fat,  is  contained.  The  cell  is,  inside  the  body,  oval  and  smooth,  becomes 
irregular  on  cooling,  angular  or  flat.  Diam.  ==  0*018  of  a  line  to  0*056.  Their 
surface  refracts  light  strongly,  the  edges  are  bright  silvery  white  when  light 
falls  upon  them.  The  vesicle  is  very  delicate ;  in  its  wall  an  oval  nucleus 
generally  appears  (even  two).  The  cell  becomes  smaller,  and  is  entirely 
soluble  in  acetic  acid. 

Development.  Fat  forms  and  becomes  consumed  very  quickly, 
probably  in  consequence  of  the  fat-cells  being  dissolved  (especially 
in  dyscratic  diseases  and  after  blood-letting),  and  the  fat  taken  up 
by  the  lymphatics  and  carried  into  the  blood. 

31.  Elastic  Tissue,  tela  elastica, 

is  when  of  some  thickness  yellow ;  elastic  but  fragile,  closely 
allied  to  the  uniting  tissue  ;  does  not  change  into  Gelatin  by 
boiling  (Berzelius),  is  insoluble  in  concentrated  acetic  acid,  solu- 
ble in  dilute  sulphuric  acid,  and  is  precipitated  from  the  solution 
by  Infus.  of  Galls,  but  not  by  ferro-cyanide  of  Potassium. 

Distribution.  The  Elastic  appears  in  connection  with  other 
tissues,  but  also  independently,  combined  as  membranes  and  flat 
ligaments,  in — 


32  GENERAL  ANATOMY. 

1.  The  yellow  ligaments  of  the  vertebral  columns :  Lig.flava, 
obturatoria  atlantis. 

2.  The  ligaments  and  membranes  of  the  Larynx,  the  Trachea, 
and  the  Bronchi. 

3.  The  elastic  fibres  of  the  (Esophagus,  in  the  cutis,  many 
fasciae  and  serous  membranes. 

4.  The  external  (not  central)  coat  of  the  arteries  (and  veins  ?). 
See  Angiology. 

The  fibres  of  this  tissue  are  strongly  serpentine,  like  the  nucleus  fibres  of 
uniting  tissue  (both  insoluble  in  acetic  acid)  ;  or  curved  and  curled,  of  an  S 
shape  (in  the  ligg.  flava)  ;  or  anastomosing  with  parallel,  neighbouring  fibres 
(in  the  arterial  coat).     The  fibrous  appearance  is  not  so  distinct  as  in  the 
structures  consisting  of  uniting  tissue.     It  is  commonly  mixed  up  with  uniting 
tissue ;  the  purest  is  presented  by  the  yellow  ligaments. 
'  Few  vessels  are  found  therein ;  nerves,  probably,  not  at  all. 
Uses.     Connection  of  bones,  for  the  boundary  of  cavities,  envelope  of  mus- 
cles, the  last  being  assisted  in  their  performance  by  the  very  extensible  elastic 
tissue. 

32.  Cartilage  tissue. 

Cartilage,  cartilagines,  ^ovfipot,  are  smooth,  firm,  elastic  and 
flexible,  more  or  less  brittle  parts,  of  a  milk  blue,  even  yellow, 
colour,  of  spec.  grav.  =  1'15;  consisting  of  a  homogeneous  base- 
ment substance,  between  which  vesicles  are  scattered,  or  even 
fibres  are  found.  We  accordingly  distinguish : 

1.  True  cartilages,  that  is,  such  as  consist  of  homogeneous  basement  sub- 
stance, containing  cavities  and  cells  with  (from  1  to  4)  nuclei,  but  seldom 
cells  containing  fat.     They  are  covered  with  a  strong  membrane  of  uniting 
tissue,  Perickondrium  which  contains  vessels,  on  their  free  surfaces.     To  them 
belong, 

a.  The  Nasal. 

b.  Cartilages  of  the  respiratory  organs  (except,  cc.  Santorim,  arytcenoid,  epi- 
glottis, corpusc.  triticea,  and  ligg.  hyothyreoid.  later  alia'). 

c.  Rib  cartilages  and  cartilage  of  proc.  xiphoideus. 

d.  Articular  cartilage  (except  the  ring  around  the  cavitat.  gknoidal,  and  the 
condylus-maxill.  inferior). 

The  rib  cartilages  break  transversely  very  easily,  and  incline  to  ossification, 
whilst  in  them,  as  in  the  thyroid  cartilage,  fibres  become  developed,  which 
are  at  first  pale,  later  yellow  and  stiff.  They  lie  close  together  in  bundles, 
and  receive  the  cartilage  cavities  between  them.  Thus  arises  the  transitional 
form  into 

2.  Fibro-cartilages,   cc.   fibrosee.     Their    basement   substance   consists    of 
darker,  harsher,  and  stronger  fibres  than  are  present  in  the  true  cartilages ; 
they  are  more  flexible  (do  not  break  so  easily),  and  more  yellow,  containing 
nucleated  cells  holding  fat  (hence  an  inclination  to  be  transformed  into  fat). 
To  them  belong : 

Ligg.  intervertebralia,  Synchondroses,  Ear  cartilages,  Epiglottis,  cartt.  Santorini, 
and  Wrisbergii,  cart,  tuba  Eustadrii,  c.  inter  articular,  of  the  sterno-clavicular 
articulation,  the  Meniscus  of  the  maxillary  articulation.  The  so-called  fibro- 


ELEMENTARY  FORMS.  33 

cartilaginous  mass  in  the  space  between  Petrous,  Sphenoid,  and  Occipital  bone 
(foram.  lacerum  anteriuLS)  consists  of  pure  uniting  tissue. 

Chemical.  The  principal  element  of  cartilage  is  Chondrin,  which  arises 
after  boiling  true  cartilages  from  fifteen  to  eighteen  hours,  and  false,  which  is 
well  supplied  with  cartilage  cells,  for  forty-eight  hours.  Cartilage  contains 
about  three-fourths  water,  nevertheless  it  does  not  readily  decompose.  Salts; 
Carb.  Soda  (most);  Sulphate  of  Soda,  Chlor.  Soda,  phosph.  Magnes.;  some 
oxyd  of  Iron. 

Vessels  and  nerves.  Most  cartilages  are  without  vessels,  but  in  connection 
with  highly  vascular  bones  and  synovial  capsules.  From  out  of  the  Peri- 
chondrium  vessels  pass  into  the  (true)  cartilages,  e.  g.,  the  ribs.  Also  the  Syn- 
chondroses  (Symphysis  pubis,  &c.)are  said  to  contain  vessels  during  pregnancy. 
In  the  ossification  of  the  thyroid,  rib,  and  fetal  cartilages  new  vessels  form. 
The  articular  cartilages  never  ossify,  but  become  rough  and  degenerate ;  in 
consequence,  the  immediate  ends  of  the  bones  grow  together  (Anchylosis). 
Cartilage  is  not  sensitive,  possessing  no  nerves. 

Upon  bone  cartilage,  see  Osteology. 

33.  Nutritious  Juice 

consists  of  a  fluid  portion,  Plasma,  and  of  a  solid,  the  microsco- 
pical corpuscles  which  are  suspended  in  the  former  in  great  num- 
bers. Plasma  (lig.  sanguinis  et  lymphx)  is  a  homogeneous  mass 
which  at  death  divides  into  a  fluid  (serum)  and  a  coagulahle 
portion  which  forms  by  enclosing  the  corpuscles,  the  blood  or 
lymph  clot,  coagulum  (Cruor.  Placenta). 

The  corpuscles  pass  through,  in  a  short  time,  several  stages  of 
development,  like  the  Organismus,  to  the  maintenance  of  which 
they  contribute.  As  the  last  stage,  as  modifications  (certainly 
only  imaginary)  of  the  nutritious  juices,  we  must  consider  those 
which  are  designated  by  the  expression  Blood,  Chyle,  and  Lymph. 

The  analogy  between  the  Plasma  and  Cytoblastema,  the  corpus- 
cles and  nucleated  cells,  has  already  been  referred  to. 

34.  1.  CHYLE,  Lymph. 

1.  Chyle.  This  is  the  milky  fluid  formed  as  the  result  of  the 
digestion  of  nutritious  substances  in  the  intestines,  and  taken  up 
from  them  by  the  lymphatics  (lacteals).  It  immediately  takes  its 
course  with  the  lymph,  which  very  soon  unites  with  it,  through 
the  large  lymphatic  trunks,  and  thus  passes  into  the  sanguineous 
system. 

The  Chyle  at  the  commencements  of  the  lymphatics  [lacteals] 
(where  it  is  not,  however,  even  more  free  from  lymph)  has  a 
milk-white  colour,  which  depends  upon  fat  globules,  and  does 
not  coagulate.  It  contains  besides 

the  fat  (C.  H.  Schultz),  very  small,  generally  round  corpuscles  (nuclei  of 
blood  corpuscles?),  which  increase  the  more  the  fat  diminishes j  the  rela- 
tive quantity  of  fibrin  and  albumen  is  smaller  than  in  lymph. 
3 


34  GENERAL  ANATOMY. 

35.  2.  Lymph  is  the  fluid  of  the  lymphatics,  flowing  into  the 
system  of  blood-vessels,  formed  from  the  surplus  of  the  blood 
plasma  and  the  destruction  of  the  particles  of  organs. 

A  thin  fluid,  colourless,  sometimes  yellowish  and  lastly  red;  alkaline  reac- 
tion, and  saltish  taste.  Contains  larger  corpuscles  which,  round  and  smooth, 
are  rather  larger  than  the  blood  corpuscles  (see  after),  of  about  0*002  to  0*005 
of  a  line  diameter;  their  shell  soluble  in  acetic  acid,  the  nucleus  insoluble; 
and  smaller,  that  is,  nuclei  without  cells;  the  Plasma  of  lymph  contains  fibrin 
which  coagulates  of  itself,  after  ten  to  fifteen  minutes,  into  a  lymph  coagulum 
which  encloses,  partly,  the  corpuscles. 

The  Serum  consists  of  92  to  96  parts  water,  albumen,  alkaline 
salts,  and  oxide  of  iron.  The  small  lymph  corpuscles,  cell-less 
nuclei,  are  metamorphosed  into  blood  discs,  but  not  so  the  perfect 
lymph  globules. 

36.  2.  BLOOD,  Sanguis, 

a  bright  red  fluid  in  those  vessels  called  arteries,  a  dark  red  in  the 
veins,  of  1'052  to  1'057  sp.  grav.  (at  -f  15°  R.),  [65°  Fahr.], 
and  saltish  taste,  easily  decomposes.  Living  blood  consists  of 
fluid  (Plasma)  and  blood  corpuscles. 

Out  of  the  vessels  the  blood  coagulates  after  5  to  7  minutes, 
and  separates  into  a  firm  portion  (coagulum,  Placenta),  and  into 
a  fluid  (Serum) ;  the  coagulum  contains  the  coagulated  fibrin, 
and  the  (red)  blood  corpuscles,  the  yellow  serum,  the  albumen, 
and  the  salts  of  the  blood. 

1.  Blood  corpuscles.  Coloured  and  colourless  are  now  dis- 
tinguished. 

a.  The  coloured,  singly  yellow,  in  heaps  appearing  red,  are  very  smooth 
and  slippery;  in  the  human  subject  flat,  round,  of  0*0025  to  0*0032  of  a  line 
diam.  (broad),  and  of  0*0008  to  0*0012  of  a  line  diam.  (thick);  very  elastic, 
soft  and  heavier  than  the  plasma.  A  nucleus  (as  we  see  in  the  blood  cor- 
puscles of  the  frog,  which  are  four  times  as  large)  is  rarely  or  never  observed 
in  those  of  man. 

The  substance  of  the  nucleus  is  fibrin  (J.  Muller,  Fr.  Simon).  The  case 
is  very  sensitive,  swells  out  in  water  and  principally  in  less  concentrated 
fluids  than  the  Serum;  shrinks  together  in  concentrated  solutions,  and  is 
soluble  in  acetic  acid. 

Inside  the  case  we  find  a  viscous  fluid,  in  which,  probably,  the  colouring 
matter,  soluble  in  water,  is  contained  (Haematin  and  Haemaphaein),  which 
amounts  to  about  0*55,  and  may  be  abstracted  by  alcohol.  The  Globulin 
(Berzelius)  is  also  a  part  of  these  contents,  probably  albumen  with  phosphate 
of  lime.  The  cases  of  the  blood  corpuscles  have  not  yet  been  chemically 
examined  alone. 

Cruor  (not  to  be  confounded  with  Haematin),  blood  red,  is  the  term  given 
to  the  mixture  of  the  cases  with  their  contents. 

6.  The  colourless  blood  corpuscles  are  somewhat  larger  than  the  coloured ; 
they  possess  a  nucleus,  and  are  more  frequently  present  in  the  serum  than  in 


ELEMENTARY  FORMS.  35 

the  blood  coagulum.  They  are  developed  from  the  Chyle  and  Lymph  cor- 
puscles, and  are  metamorphosed  into  coloured  blood  corpuscles,  without 
nuclei. 

2.  Blood  Plasma,  the  fluid  element  of  the  blood,  contains,  dis- 
solved in  water : 

a.  Fibrin,  more  in  males,  in  pregnant  women,  and  in  inflammations,  par- 
ticularly of  the  lungs. 

b.  Albumen,  more  in  females  than  in  males. 

c.  Fat,  in  indefinite  quantity;  the  greater  the  quantity,  so  much  the  more 
white  the  serum. 

d.  Extractive  matters. 

e.  (Peculiar  smelling  substance,  which  is  especially  brought  out  by  sul- 
phuric acid,  and  may  serve  to  distinguish  between  animal  and  human  blood.) 
(Barruel.) 

f.  Salts:     1.  Soda   and   lime,  with   lactic,  fatty,  carbonic,  sulphuric,   and 

phosphatic  acids ;  particularly  chlor.  sodium  (common  salt). 

2.  Lactate  ammonia. 

3.  Phosphor.  Lime  and  Magnesia. 

Oxide  of  iron  is  found  in  the  blood  in  very  indefinite  quantity,  only.  Bile, 
urea,  as  well  as  sugar  also,  are  found  probably  only  in  diseased  blood. 

Although  the  composition  of  the  healthy  blood  differs  according  to  the  age, 
sex,  &c.  of  man,  there  always  remains,  nevertheless,  a  certain  relative  propor- 
tion of  the  elements  before  quoted.    F.  Simon  gives  the  following  proportions 
as  the  result  of  an  analysis  of  healthy  venous  blood. 
1000  parts  of  blood  consist  of: 

Water  .....  791*900 
Solid  residue  ....  208-100 

Fibrin         .....         2-011 

Fat 1-978 

Albumen 75-590 

Globulin  .....  105-165 
Haematin  .....  7-181 
Extractive  matter  and  salts  .  .  14-174 

The  arterial  blood  contains  less  solid  elements,  less  fat,  albumen,  haematin, 
extractive   matters,  and   salts.     The  blood  also  of  ven.  porta,,  that  of  the 
hepatic  veins,  &c.,  present  each  again  particular  differences. 
Coats  of  vessels* see  Angiology. 
Muscular  tissue,  see  Myology. 
Tissue  of  nerves,  see  Neurology. 

37.  Tissue  of  Glands. 

Glands,  glandulse,  was  the  name  formerly  given  to  all  soft, 
roundish,  highly  vascular  organs,  with  or  without  excretory  ducts. 
They  are  organs  of  the  most  different  sizes,  which  take  away 
certain  substances  from  the  blood,  for  the  purpose  of  conducting 
them  (as  such  or  metamorphosed)  either  immediately  to  the  sur- 
face of  the  body,  or  first  into  cavities,  where  they  become  mixed 
with  their  contents.  They  are  therefore  divided  into  membranous 
and  vascular  glands. 

1.  Membranous,  or  glands   of  mucous  membranes,  possess  a 


36  GENERAL  ANATOMY. 

cavity  which  constantly,  or  at  times,  is  in  communication  by 
canals  or  immediately  with  the  surface  of  the  body.  The  most 
simple  are  round  vesicles  (cells)  clear  as  water,  of  O'Ol  to  0*03 
of  a  line  diam.,  formed  of  a  structureless  membrane,  with  granu- 
lar contents  and  closed,  lying  in  the  substance  of  the  mucous 
membrane,  without  elevating  it.  Similar,  but  larger,  are  the  gl. 
tartaricse  of  the  gums,  gl.  agminatss  and  solitaries  of  the  small 
intestines  and  the  egg  in  the  ovary.  They  open  at  times.  We 
therefore  distinguish  simple  (gl.  simplices,  cryptse)  and  compound 
glands  (gl.  compositse),  and  among  these  gl.  conglomerate,  which 
form  a  mass,  with  one  or  few  excretory  ducts,  and  gl.  aggregate, 
which  only  lie  close  together,  and  possess  separate  excretory 
ducts.  Forms  of  glands  : 

a.  Glands  like  blind  sacs  consist  of  a  series  of  vesicles  opening  into  one 
another,  the  first  of  which  is  closed,  whilst  the  last  opens  upon  the  mucous 
membrane  or  into  an  excretory  duct.     The  shortest  are  the  glands  of  Lie- 
berkuhn  in  the  small  intestines,  filled  with  viscous  granular  contents;  they 
are  longer  upon  the  large,  particularly  in  the  rectum.     More  in  clusters,  but 
unarranged,  appear  the  gl.  pylorica  (gastric  fluid  glands),  the  gl.  Meibomiance. 
of  the  eyelids,  and  the  glands  of  the  caruncula  lacrymalis.     Wound  up  like  a 
ball  of  thread,  convoluted:  sweat  glands  of  the  skin  and  the  ceruminous  of 
the  ear. 

b.  Glands  in  the  form  of  a  bunch  of  currants,  racemose;  are  so  composed, 
that  single  vesicles  are  united  into  one  lobule  with  a  common  excretory  duct. 
The  primary  lobules   are  associated  together   by  uniting  tissue    into  larger 
secondary,  and  these  into  tertiary,  which  all  communicate  by  the  common 
trunk  of  the  entire  gland  only.     The  whole  gland  possesses  a  more  or  less 
condensed  covering  of  uniting  tissue,  never  a  serous.     These  racemose  glands 
are  distinguished  from  one  another,  only,  by  their  mass,  size,  and  the  rami- 
fications of  their  excretory  ducts.     The  lacrymal,  mammary,  and  prostate 
glands  are  remarkable,  since  in  them  a  common  excretory  duct  is  wanting, 
and  the  mass  of  several  gland  lobules  appears  joined  together.     Besides  these 
?uid  the  accumulated  (gl.  conglobatce)  Tonsillae,  to  this  class  belong  the  small 
mucous  glands  of  the  lips  and  cheeks,  of  the  palate,  tongue,  and  oesophagus; 
of  the  Larynx,  Trachea,  Bronchi,  gl.  Brwuneriavuz  of  the  small  intestines,  the 
mucous  glands  of  the  Vagina ;  the  salivary  glands,  the  Pancreas ;  gl.  Cowperi 
and  BartholiniancE. 

c.  Reteform  glands  consisting  of  tubes  (therefore  gl.  tubulosce'),  which,  like 
the  blood-vessels,  are  united  by  anastomoses  into  a  network,  and  never  or 
rarely   terminate   blindly,   being,   besides,   many   times   convoluted.     Their 
excretory  ducts  open  into   bladder-like  receptacles  for  the  secretions  (as    in 
the  liver).     To  this  class  belong  the  kidneys  and  testicles.     They  are  sur- 
rounded by  a  fibrous  membrane,  which  in  the  last  sends  septae  inwards,  so 
that  the  lobules  may  be  distinguished. 

The  vessels  of  the  glands  are  very  numerous.  In  the  Liver,  Kidneys,  and 
Testicles  they  pass  in  and  out  at  the  Hilus;  in  the  rest  of  the  glands  they 
are  distributed  from  different  points  upon  the  surface,  since  they  follow  the 
uniting  tissue  between  the  lobes,  lobules,  and  tubules. 

Nerves  form  plexuses  upon  the  arteries,  and  accompany  these  into  the  in- 
terior of  the  glands. 


SPECIAL  ANATOMY.  37 

2.  Vascular  glands.  These  are  the  Thyroid  and  Thymus 
glands,  Spleen  and  Caps,  supra  renales.  They  are  soft,  round, 
or  lobulated,  pale  or  dark  red,  without  excretory  ducts.  In  the 
thyroid  and  thymus  glands  small  cavities  are  found  filled  with  a 
milky  fluid.  The  parenchyma  consists,  in  all,  of  granules  which 
fill  up  the  spaces  between  the  vessels.  They  are,  proportionably, 
not  superabundantly,  provided  with  blood  and  lymph  vessels. 
In  the  spleen  and  supra  renal  capsules  the  vessels  quickly  pass 
into  capillary  ramifications,  without  marked  anastomoses.  In 
the  supra  renal  capsules  a  greater  abundance  of  nerves  prevails. 
It  is  pretended  that  their  function  consists  in  producing  a  change 
in  the  composition  of  the  blood ;  of  what  kind  is  unknown. 

With  these  may  be  classed  the  Lymphatic  glands,  which 
consist  of  a  convoluted  arrangement  of  Lymphatic  vessels  passing 
uninterruptedly  through  them  (vasa  afferentia  and  efferentia). 
The  alteration  effected  in  the  blood  and  lymph  as  they  pass  through 
them  is  even  still  doubtful. 


SPECIAL  ANATOMY. 

38.  General  cutaneous  covering  of  the  body. 

The  external  surface  of  the  body  is  invested  by  a  compound 
membrane,  which,  at  the  openings  of  the  internal  surface,  turns 
inwards,  and  lines  the  open  cavities,  as  mucous  membrane. 

39.  I.  External  skin,  cutis. 

It  invests  the  whole  of  the  outer  surface  of  the  body,  is  itself 
covered  externally  with  the  epidermis  (see  Epithelium),  internally 
with  loose  uniting  tissue,  and  consists  of  a  very  filamentous, 
interwoven  uniting  tissue,  with  glands,  nerves,  and  vessels :  this 
is  the  Corium. 

1.  Epidermis,  cuticle,  is  a  connected,  nowhere  perforated,  more  or  less 
strong  layer  of  pavement  epithelium.  Its  usual  thickness  measures  one- 
twentieth  of  a  line,  but  in  the  palm  of  the  hand  and  under  the  sole  of  the 
foot  equals  £  to  1  line.  In  life  colourless  and  diaphanous,  it  becomes  in  death 
white  and  transparent :  is  little  elastic,  but  brittle,  curling  up  together  when 
detached  from  the  cutis,  peels  off,  especially  in  cutaneous  eruptions,  and  rises 
in  blisters  on  the  application  of  heat  It  does  not  decompose ;  it  is  coloured, 
by  sulphuric  acid,  brown,  by  nitric,  yellow,  by  hyd.  chloric,  not  at  all,  by  ni- 
trate of  silver,  first  milky  white,  then  greyish  blue,  by  hyd.  chlor.  of  gold,  pur- 
plish red.  Caustic  alkalies  dissolve  it.  Elements : — keratin  equal  to  O94, 
gelatin  equal  to  0'5,  lactic  acid,  sulphate,  phosphate  of  potash  and  lime. 


38  SPECIAL  ANATOMY. 

The  unevenness  of  the  epidermis  depends  upon  that  of  the  corium  which  is 
found  underneath  it.  There  are  elevations,  grooves  and  fossae,  from  the  last 
of  which  hair,  sweat  or  fat,  with  which  the  cuticle  is  constantly  saturated,  ap- 
pears. By  boiling,  the  epidermis  easily  separates,  especially  in  the  palm  of 
the  hand  or  sole  of  the  foot,  into  an  external  and  an  internal  layer.  The  in- 
ternal layer  (rete  Malpighii),  improperly  regarded  as  a  peculiar  membrane,  is 
softer,  but  not  essentially  different  from  the  external  layer,  into  which,  by  de- 
grees, it  passes ;  its  reteform  appearance  arises  from  rearing  out  the  nervous 
papillae  of  the  corium,  otherwise  it  is  granular,  whilst  the  external  layer  ap- 
pears striated.  In  the  Negro  the  rete  Malpighii  is,  likewise,  nothing  else  but 
this  internal  layer  with  black  pigment  adherent  to  it. 

2.  Corium,  true  skin,  is  a  soft,  at  the  same  time  strong,  dense,  and  very  ex- 
tensible organ,  of  a  red  colour  and  variable  strength ;  thickest  in  the  surfaces 
of  the  foot  and  hand,  stronger  in  the  male  than  in  the  female,  and  very  deli- 
cate on  the  eyelid  and  the  glans  penis.  Upon  its  external  free  surface  we 
observe  folds,  especially  in  places  which  are  subject  to  extension  (in  the  palm 
of  the  hand,  upon  the  dorsum  of  the  fingers,  on  the  foreskin).  Other  folds 
are  formed  by  means  of  the  muscles,  which  act  upon  the  skin  (e.  g.,  on  the 
forehead).  These,  in  time,  remain  constantly  (as  wrinkles),  like  the  folds 
which  arise  upon  the  abdomen,  in  consequence  of  the  greater  extension,  after 
pregnancy  and  dropsy ;  in  old  age  they  arise  from  the  loss  of  the  fat. 

The  skin  is  moveable  by  proper  cutaneous  muscles  (in  man  on 
the  face  and  in  the  hand  only) ;  by  a  very  fatty,  as  well  as  ex- 
panded uniting  tissue  in  the  form  of  a  membrane  (fascia  super- 
faialis).  See  Myology. 

The  external  skin  is  both  an  organ  of  touch  and  of  secretion, 
by  means  of  the  tactile  papillae,  arranged  in  rows,  upon  the  linear 
elevations,  the  sweat  and  sebaceous  glands,  and  the  glandules  of 
the  hair  follicles  found  in  the  depressions  between  them. 

a.  Tactile,  sensitive  papillae,  Papilla  corii,  consist  of  closely   compressed 
fasciculi  of  uniting  tissue,  in  the  interior  of  which  a  vascular  and  nervous  loop 
passes.     (The  nerves  do  not  terminate  like  a  hair-pencil  or  club,  but  are  re- 
flected, and  return  to  the  surface  of  the  skin.)     The  Papillae  lie  in  the  upper- 
most layer  of  the  Corium,  covered  by  the  Epidermis,  which  fills  up,  partly  or 
entirely,  the  depressions  between  them,  and  therefore  gives  to  the  skin  either 
a  grooved  or  even  appearance.     We  distinguish  filamentous  and  club-shaped 
papillae.     The  finer  they  are,  so  much  the  more  crowded  they  stand,  and  the 
more  sensitive  is  the  skin  (e.  g..  on  the  inner  surfaces  of  the  fingers,  in  the 
sole  of  the  foot,  on  the  nipple,  the  lips,  glans  penis,  and  clitoris). 

b.  Sebaceous  follicles,  folliculi  sebacei,  spread  over  the  whole  surface  of  the 
body  (with  the  exception  of  the  palm  and  sole),  found  especially  at  the  points 
of  transition  of  the  external  skin  into  the  mucous  membrane.     The  larger 
open  immediately  upon  the  skin,  namely  in  places  devoid  of  hair  (e.  g.,  the 
glans  penis,  the  nyrnphse) ;  they  do  not  consist,  probably,  of  simple  follicles. 
but  must  be  enumerated  with  the  racemose  glands ;  the  smallest  lie  in  pairs 
on  either  side  of  a  hair  follicle,  and  open  immediately  into  it.     These  last 
consist  of  small  fat  cells  which  lie  dispersed  in  round  heaps  of  0*007  of  a 
line  in  diameter.     They  contain  an  oil,  the  grease  of  the  skin,  sebum  cutaneum, 
which  makes  the  skin  and  hair  pliable.     To  the  glands  of  the  hair  follicles 
belong  also,  probably,  Eichhorn's  lymph  spaces  of  the  cutis. 


SPECIAL  ANATOMY.  39 

c.  Perspiratory  glands,  organa  sudoripara,  consist  of  a  blind  tube,  which 
reaches  downwards  deeply  into  the  cutis  as  far  as  the  layer  of  fat  (where  it 
is  convoluted),  and  opens  with  a  spiral  excretory  duct,  which  is  lined  with 
pavement  epithelium,  like  a  funnel  upon  the  surface  of  the  skin.  Their 
openings  (pores)  are  placed  in  the  grooves  between  the  Papillae.  [On  the 
ridges.  TRANS.]  They  secrete  a  fluid  filled  with  mucous  corpuscles  and  epi- 
dermis scales.  Similar  in  structure  are  the  Ceruminous  glands  of  the  ear,  the 
cells  and  contents  of  which,  however,  are  different ;  their  secretion  contains 
lat  vesicles. 

40.         II.  Mucous  membrane,  Membrana  mucosa. 

It  lines  the  internal  cavities,  since  it  penetrates,  as  the  immediate 
continuation  of  the  Cutis,  at  the  external  openings  into  the  in- 
terior, passes  through  the  whole  digestive  canal,  and  covers  the 
respiratory  organs,  glands,  urinary  and  genital  organs.  It  is  soft, 
like  velvet,  plentifully  supplied  with  vessels  and  nerves,  thicker 
or  thinner,  according  to  situation,  greyish  white  or  red,  and  par- 
ticularly strongly  developed  at  the  external  openings.  It  consists, 
like  the  Cutis,  of  Epithelium  and  a  peculiar  membrane  of  uniting 
tissue,  which  is  connected  to  a  muscular  layer  by  more  or  less 
strongly  developed  uniting  tissue  (tunica  nervea).  One  or  more 
of  these  layers  are  lost  as  they  proceed.  The  epithelium  is  thin- 
ner and  more  slimy  (as  the  so-called  rete  Malpighii  occupies  the 
surface),  the  uniting  tissue  is  more  delicate,  e.  g.,  in  the  intestines, 
unites  with  the  fibrous  periosteum,  where  the  mucous  membrane 
lies  upon  bones  (when  the  muscular  layer  is  lost) ;  or  is  remarka- 
ble for  elastic  fibres  in  the  Trachaea  and  the  Bronchi. 

Like  the  external  skin,  it  is  beset  with  projections  (folds,  valves, 
villi,  and  papillae)  and  depressions  (sulci  and  fossae). 

a.  The  folds  are  for  the  purpose  of  increasing  the  superficies  in  the  interior 
of  canals  and  cavities,  where  absorption,  secretion,  or  sensation  is  the  object ; 
and  may.  after  removing  the  muscular  coat,  be  drawn  out  (plica  Kerkring.  in 
the  intestines,  columna  rugarum  in  the  Vagina,  &c.). 

b.  The  papillae  are  also  present,  especially  in  places  which  are  designedly 
very  sensitive  to  touch,  e.  g.,  the  lips,  gums,  tongue,  palate,  labia  externa, 
vagina. 

c.  The  villi  are  present  upon  the  mucous  membrane  of  the  small  intestines 
only;  they  resemble  the  filamentous  papillae,  but  contain  (instead  of  vascular 
and  nervous  loops),  lymphatic  rete,  which  have  vascular  rete  spun  all  round 
them. 

d.  The  fossae  are  the  openings  of  the  mucous  glandules,  folliculi  rmtcosi. 
The  simple  mucous  glandules  are  not  always  closed  follicles  (gl.  solitaries  and 
Peyeriana),  over  which  the  mucous  membrane,  with  its  villi,  passes.     When 
open,  they  appear  to  be  inversions  of  the  mucous  membrane.     To  the  class  of 
glands  with  blind  sacs  belong  the  dispersed  gl.  solitaria,  the  amassed  gl.  Pey- 
triancR,  gl.  LieberkuhniantB  in  the  small  intestines,  the  closed  gL  tartariccE  in  the 
gums,  and  the  glands  for  secreting  the  gastric  juice  in  the  pylorus ;  to  the 


40  SPECIAL  ANATOMY. 

racemose,  the  glands  of  the  lips,  cheeks,  tongue,  (Esophagus,  larynx,  &c.,  gl. 
Brunneriana  of  the  small  intestines,  &c. 

We  may  distinguish  three  separated  tracks  of  the  raucous  mem- 
brane. 

1.  The  digestive  and  respiratory  mucous  membrane  commences 
in  common  at  the  mouth,  continues  into  the  excretory  ducts  of 
the  salivary  glands,  upon  the  nose,  through  the  lacrymal  canals, 
and  punctae  upon  the  fibrous  coat  of  the  eye,  through  the  tuba 
Eustachii  upon  the  cavity  of  the  tympanum ;  it  then  passes  on 
the  one  hand  from  the  Pharynx  through  the  Larynx  to  the  Tra- 
chea and  Lungs,  on  the   other  through  the  resophagus   to  the 
stomach  and  intestines. 

2.  The  mucous  membrane  of  the  genital  and  urinary  organs  is 
more  separated  in  the  female  than  in  the  male.     The  urinary 
mucous  membrane,  commencing  from  the  external  opening  of  the 
genitals,  terminates   in  the  excretory  ducts  of  the  kidneys,  and 
continues  in  the  male  through  those  of  the  Prostate,  into  the  semi- 
nal vesicles,  ducts,  and  testicles.    In  the  female  the  genital  mucous 
membrane  goes  from  the  Vagina  into  the  Uterus  and  tubes,  and 
opens  freely  into  the  abdomen,  where  the  serous  cavity  of  the 
peritoneum  communicates  with  it. 

3.  The  mucous  membrane  of  the  mammary  gland  commences 
at  the  nipple,  and  terminates  in  the  closed  extremities  of  the  milk 
ducts. 

Division  of  Special  Anatomy. 

1.  Osteology  treats  of  the  bones. 

2.  Arthrologia  (syndesmologia),  of  the  connection  of  the  bones. 

3.  Myologia,  of  the  muscles. 

4.  Splanchnologia,  of  the  viscera  and  organs  of  the  senses. 

5.  Angiologia,  of  the  vessels. 

6.  Neurologia,  of  the  nerves. 


OF  THE  BONES. 

OSTEOLOGIA. 


"  The  frontispiece  Represents  Galen  contemplating  the  skeleton  of  a  robber 
who,  being  killed  by  a  traveller,  had  his  bones  picked  in  two  days  by  vul- 
tures. This  opportunity  he  mentions  as  a  piece  of  good  fortune,  though  he 
had  seen  another  skeleton  which  was  accidentally  washed  out  of  a  burying 
place,  by  the  overflowing  of  a  river,  besides  one  which  was  shown  in  a  public 
school  at  Alexandria,  which  he  thought  was  worth  the  trouble  of  any  one  to 
go  on  purpose  to  study" — CHESELDEX.  Osteographia. 


THE   BONES. 

LITERATURE. 

Minute  Structure : — 
Art.  "  Bone"  in  Cyclopaedia  of  Anat.  and  Phys..  at  the  end  of  which  references 

are  given. 
Anton.  V.  Leeuvenhoek.     Microscopical  Observations  made  about  milk,  bones. 

the  brain,  &c.     Philos.  Trans.,  Year  1674,  p.  121 — 128. — Observations  on 

the  structure  of  teeth  and  other  bones.     Ibid.   1678,  p.   1002 — 1720,  p. 

91—94. 
Clapton  Havers.     Osteologia  Nova,  or  some  new  observations  of  the  bones,  &c. 

Lond.  1691. 
Goodsir,  J.  $  H.     Anat.  and  Path.  Obs.,  p.  64.     Edinburgh,  1845. 

Osteogenesis : — 
Mutter's  Physiology,  vol.  i. 
/.  Howship.     Exp.  and  Obs.  in  order  to  ascertain  the  means  employed  by  the 

animal  economy  in  the  formation  of  a  bone.     Med.  Chir.  Trans.,  vol.  vi. 

1815. 

Reparation : — 
B.  B.  Cooper.     Experimental  inquiry  on  the  reparation  after  simple  fracture 

of  bones.     Guy's  Hosp.  Rep.,  vol.  ii.  p.  179.     Plates. 
Paget.    Influence  of  Madder,  &c.     Med.  Gazette,  vol.  xxv. 

Descriptive  Anatomy : — 

B.  B.  Cooper,  F.  R.  S.     Lectures  on  Osteology,  &c.,  in  one  volume.     1844. 
J.  F.  South.     A  short  Description  of  the  Bones.     1825.     There  is  a  new 

edition. 

Ward,  F.  0.     Outlines  of  Human  Osteology. 
Alex.  Monro.     The   Anatomy  of  the  Human  Bones,  &c.     3d  edit.  1741.  and 

after  editions. 

Will.  Cheselden.     Osteographia,  or  the  Anatomy  of  the  Bones.     Fol.  1733. 
John  Bell.     The  Anatomy  of  the  Bones,  &c.     1793. 

T.  W.  King.     On  the  Episternal  Bones  in  Man.     Guy's  Hosp.  Rep.,  vol.  v. 
B.  B.  Cooper.     Changes  effected  by  Age  in  Neck  of  Femur.     See  a  paper, 

Guy's  Hosp.  Rep.,  vol.  iii.,  2d  series,  p.  211. 
Bell,  Sir  C.     Animal  Mechanics.     Lib.  of  Useful  Knowledge. 
Boyer.     On  the  Bones.     Farrell.     \  807. 


43 


41.  THE  BONES,  OSSrf, 

are  hard,  dry  bodies,  of  various  shapes.  United  into  a  moveable 
framework,  which  serves  as  a  point  of  support  to  the  rest  of  the 
organs  of  the  body,  they  form,  on  the  one  hand,  cavities  for  their 
protection,  and,  on  the  other,  levers  to  approximate  separate 
organs  towards  one  another,  which  are  set  in  motion  by  peculiar 
contractile  organs,  the  muscles. 

Chemical  analysis  resolves  the  osseous  mass  into  the  following^ 
constituents,  abstractedly  of  the  fat,  the  vessels,  &c.,  found  in 
bone: — 

1.  Cartilage,  the  essential,  organic  part  of  bone  tissue.     It  consists  of  cells, 
contains  cavities  and  tubules,  and  is  only  distinguished  from  permanent  car- 
tilage by  the  fact  that  the  bone  earth  is  deposited  in  it,  and  condenses  it.     It 
is  obtained  by  macerating  bone  in  dilute  hydrochloric  acid.     It  is  soft,  flexible, 
elastic,  soluble  in  a  warm  solution  of  Potash,  and  converted  into  gelatin  by 
hot  water. 

2.  Bone  earth,  which  is  especially  phosphate  and  carbonate  of  lime,  with 
some  Magnesia  and  Fluoride  of  Calcium. 

The  proportion  of  cartilage  is  about  0-33 ;  of  the  bone  earth,  O67.  The 
relative  proportions  differ,  however,  according  to  age,  health,  and  the  bones 
themselves. 

Figure  of  the  bones.     Three  forms  are  described: — 

1.  Long,  or  cylindrical ;  2.  Flat;   3.  Short,  or  thick  bones. 

1.  Long  bones,  ossa  cylindrica,  possess  a  large  cavity,  occupied 
by  a  few  cells,  and  filled  with  fat  and  vessels.     Externally  they 
are  surrounded  by  compact  substance,  and  they  generally  serve 
as  levers.     The  centre  part  is  called  body,  diophysis ;  the  ex- 
tremities, apophyses,  are  covered  with  cartilage,  and  are  of  the 
same  construction  as  the  short  bones. 

2.  Short  bones,  consisting  of  a  spongy  mass,  formed  of  deli- 
cate osseous  laminae  connected  together:  subs,  spongiosa,  which 
on  the  surface  is  closely  compressed,  and  thus  surrounded  by  a 
smooth  but  thin  osseous  layer,  the  cortical  portion  (subs,  corti- 
calis) ;  as  the  bones  of  the  carpal  and  tarsal  articulations. 

3.  Flat  bones  enclose  a  thin  layer  of  spongy  substance,  diploe, 
between  two  closely  approximating  planes  of  solid  cortical  sub- 
stance.    They  form  cavities. 

42.  Texture  of  the  Bones. 

The  spongy  and  cortical  substances  consist  of  narrow  cylindri- 
cal canaliculi,  medullary  canals  [canals  of  Havers],  which  form  a 
network,  and  when  they  take  a  determinate  course  give  a  fibrous 
appearance  to  the  bone.  They  open  on  one  side  upon  the  exter- 
nal surface,  on  the  other  side  into  the  cavity  of  the  bone  or  the 


44  SPECIAL  ANATOMY. 

cell-shaped  interspaces  (medullary  cells)  of  the  spongy  substance, 
and  contain  a  loose,  vascular  areola  tissue  with  numerous  fat  cells, 
the  marrow  of  the  bone,  medulla  ossium.  The  narrowest,  from 
0.005  to  0*002  of  an  inch  in  diameter,  lie  immediately  upon  the 
external  surface  of  the  bone.  The  medullary  canals  are  surround- 
ed by  from  four  to  twelve  concentric 

Osseous  plates,  lamella,  which  take  a  wavy  course,  and  are  perforated  by 
short  fibres,  or  by  rectangular,  narrow  canaliculi,  the  calcigerous  tubes.  Be- 
tween the  lamellae  in  the  homogeneous  basement  tissue  of  the  osseous  car- 
tilage, clear  spots,  or  corpuscles  having  dark  edges,  are  disposed ;  these  are  the 

Bone  corpuscles,  lacunae,  oval,  disc-like  cavities,  filled  with  granular  matter, 
from  which,  in  a  stellate  manner,  there  pass  off  on  all  sides  the 

Calcigerous  canals,  extremely  delicate  tubules,  with  numerous  ramifications, 
in  which  the  osseous  matter  or  lime  is  found  as  a  fine  white  precipitate. 

Membrane  of  Bones.  The  external  surface  of  bones  is  covered  by  Perios- 
teum, and  this  again  by  Epithelium,  in  the  cavities  of  the  nose  ciliated;  but 
the  articular  extremities  terminated  by  cartilage  are  uncovered,  and  therefore 
uneven.  Here  the  medullary  canals  terminate  in  blind  extremities. 

Internal  membrane  of  Bones,  Memb.  Medullaris,  is  nothing  but  the  outer  sur- 
face of  the  delicate  areolar  tissue  which  attaches  the  medullary  matter  loosely 
to  the  internal  surface  of  the  osseous  tubes. 

Vessels.  In  the  periosteum  a  close  vascular  rete  is  placed,  the  fine  (arte- 
rial) ramusculi  of  which  enter  the  medullary  canaliculi  by  the  innumerable 
openings  in  the  cortical  substance,  again  interlace  with  one  another,  and 
anastomose  with  the  vascular  rete  of  the  cavity  of  the  bone  or  medullary 
cells.  This  receives  its  blood  from  larger  vessels,  art.  nutritive,  one  of  which 
enters  through  a  large  foramen  nutritium  about  the  middle  of  each  (tubular) 
bone.  The  first  nourish  the  substance  of  the  bone;  the  last  the  medulla. 
The  venous  blood  is  returned  partly  by  vencE  nutrition  which  accompany,  at 
least,  the  large  art.  nutrit.  partly  through  peculiar  canals,  which  are  found  in 
the  diploe  of  the  flat  bones.  From  these  canals  the  thin-walled,  valveless 
veins  pass  out  into  the  periosteum.  They  cannot  be  injected  from  the  ar- 
teries. 

Lymphatics  are  demonstrated  in  the  medulla,  but  not  yet,  with  certainty, 
in  bone. 

The  existence  of  nerves  is  upheld  by  the  sensation  accompanying  inflam- 
mation of  the  medulla.  The  bone  substance  itself  is  without  sensation. 

[The  periosteum  is  supplied,  plentifully,  with  nerves.     TRANS.] 

43.  Development  of  bone,  Osteogenesis. 

In  the  embryo  a  solid  cartilage  at  first  appears,  cartilago  for- 
mativa,  seu  ossescens,  which  consists  of  a  mass  of  homogeneous 
cells,  in  the  centre  of  which  are  formed  the  medullary  canaliculi, 
surrounded  by  capillary  vessels.  In  the  parietes  of  the  canaliculi, 
and  in  the  lamellae,  the  lacunae,  and  calcigerous  canaliculi  ap- 
pear, and  after  that  the  deposit  of  lime  commences,  at  first  in 
the  cartilaginous  substance,  next  in  the  canaliculi ;  but  it  is  unde- 
cided whether  or  not  the  earthy  matter  is  chemically  united  with 


THE  BONES.  45 

the  cartilage.  Ossification  commences  in  the  cylindrical  and  in 
the  flat  bones  which  appear  in  pairs,  from  the  centre  spreading 
outwards  towards  the  extremities  and  surfaces ;  in  the  azygos 
and  short  bones,  vertebrae,  e.  g.,  in  two  or  several  symmetrical 
points,  puncta  ossijicationis.  It  is  earliest  in  the  clavicle,  se- 
cond month  of  the  embryo,  and  jaws,  latest  in  the  os  pisiforme, 
sixth  to  twelfth  year.  Sutures  arise  by  the  meeting  together  of 
ossified  parts  which,  as  cartilage,  were  separated,  e.  g.,  in  the 
skull.  Many  foramina  and  canals  are  in  the  commencement 
bounded  by  several  separate  pieces,  e.  g.,  foram.  magnum 
canal,  spinalis.  The  extremities  of  the  cylindrical  bones  are  in 
the  cartilaginous  state  separate  from  the  central  portion  for  some 
time  after  birth,  and  unite  at  last  into  one  bone. 

Abnormal  osseous  development  frequently  appears  in  tendons  and  cartilages, 
in  the  ovary,  on  the  sternum,  on  the  bones  much  used,  &c. 

44.  Particular  parts  of  the  Bones. 

The  skeleton  is  but  a  system  of  vertebrae  ;  the  bones  must  there- 
fore be  regarded  as  more  or  less  perfect  or  metamorphosed  ver- 
tebrae. As  in  these,  so  in  other  bones,  we  find  a  body  and  con- 
necting parts  ;  the  former,  serving  generally  for  the  attachment  of 
muscles  and  ligaments,  encloses  cavities  and  passages  ;  the  latter, 
particularly  assisting  in  the  formation  of  joints. 

1.  Articular  portions,     a.    Elevations,  smooth,  covered   with 

cartilage : — 

1.  Head,  caput,  capitulum,  a  segment  of  a  sphere  upon  a  small  neck  (cotfwwi). 

2.  Condyle,  condylus,  semi-oval.      Hereto  also  belongs  the  processus,  process 
(pr.  obliquus). 

b.  Depressions ;  smooth,  covered  with  cartilage : — 

1.  Glenoid  cavity,  a  smooth  fossa  (e.  g.,  of  the  Scapula). 

12.  Cotyloid  cavity,  cup-like,  deep,  circular  (e.  g.,  of  the  hip  bone). 

2.  Elevations  for  the  attachment  of  muscles  and  ligaments: — 

1.  Projections,  tuber,  tuberositas,  protuberaniia,  tuberculum,  zygoma,  trochanter. 

2.  Spine  (sharp-pointed),  spina  (spina  tibia,  ilei,  processus  spinosus). 

3.  Crest,  arista,  broad,  long. 

4.  Lines,  linea  (long,  narrow),  e.  g.,  linea  semicircularis,  1.  aspera. 

5.  Process,  procesms,  e.  g.,  pr.  Mastoideus,  styloid,  pterygaid,  transvergus. 

6.  Branch,  ramus  (thick,  long). 

3.  Depressions,  not  assisting  in  the  formation  of  joints: — 

1.  Fossa,  fovea  (flat);  the  entrance  wider  than  the  floor;  e.  g.,  /.  parietalis 
lacrymalis. 


46  SPECIAL  ANATOMY. 

2.  Inlet,  sinus,  a  cavity  with  a  narrow  opening,  e.  g.,  sinus  Maxillaris ;  cells, 
celhda,  similar,  but  smaller. 

3.  Grooves,  sulcus. 

4.  Incision,  incisura,  notch  (on  the  edges). 

5.  Impression,  impressio. 

4.  Perforations: 

1.  Hole,  foramen  ;  hiatus  (small). 

2.  Fissures,  fissura  (long  and  narrow). 

3.  Canals,  canalis,  ductus. 

45,  Conjunction  of  the  Bones. 

I.  Immoveable  conjunction,  synarthrosis.     The  edges  of  the 
bones  rest  against  each  other,  and  are  joined  by  sutures.     The 
edges  grasping  one  another  from  opposite  sides  by  indentations, 
form  a  true,  but  when  merely  overlying  each  other,  a  false  suture. 

a.  True  suture,  sutura  vera. — We  distinguish : 

1.  S.  dentata,  where  the  indentations  are  simple,  long  and  vertical,  like 
teeth  ;  e.  g.,  the  sagittal  suture. 

2.  8.  serrata,  when  they  are  simple  but  oblique,  like  a  saw;  e.  g.,  the 
coronal  suture. 

3.  S.  limbosa,  when  the  principal  indentations  are  provided  with  small 
lateral  ones ;  e.  g.,  the  lambdoidal  suture. 

b.  False  suture,  sutura  spuria. 

\ .  S.  Squamosa,  scale  suture ;  the  rough  edge  of  one  bone  overlying  that 

of  the  other. 

2.  Harmonia ;  the  rough  edges  merely  meeting  together. 
Gompkosis  is  that  conjunction  in  which  the  teeth  extend  in  a  wedge-like 
manner  into  the  cavities  of  the  indented  edge. 

II.  Moveable  conjunction. 

a.  Close  conjunction — amphiarthrosis.     The  bones  coming  immediately  in 
contact  or  connected  by  ligaments,  can  only  glide  a  little  on  one  another,  e.  g., 
the  carpal  and  tarsal  bones.     The  junction  at  the  pubes,  called  symphysis,  is 
effected  by  cartilage  and  ligaments ;  the  union  of  the  hip  bones,  synchondrosis, 
by  the  interposition  of  cartilage  alone. 

b.  Peculiar  articular  conjunction,  diarthrosis,  articulatio. 

1.  Hinge,  angular  joint,  ginglymus. — Formed  by  two  (long)  bones  placed 
at  an  angle,  the  one  describing  with  the  other  an  obtuse,  right,  or  acute 
angle. 

2.  Rolling  or  rotatory  joint,  rotatio,  s.  trockoides. — One  bone  moving  upon  a 
surface  lying  parallel  to  it  in  a  semicircle  or  less,  e.  g.,  radius  and  atlas. 

3.  Ball  and  socket  joint,  enarthrosis. — The  movement  is  free  in  all  di- 
rections, circular ;  e.  g.,  hip  joint. 

4.  Free  joint,  arthrodia. — The  articular  head  is  not  deeply  fixed  in  the 
articular  cavity,  as  in  the  one  above,  but  moves  upon  the  articular  sur- 
face ;  e.  g.,  shoulder  joint,  thumb. 


THE  BONES.  47 

46.  I.  THE  HEAD,  caput. 

The  twenty-two  bones  of  the  head  may  be  divided  into  two 
classes  ;  the  bones  of  the  cranium,  of  the  skull,  ossa  cranii,  7, 
and  the  bones  of  the  face,  ossafaciei,  15. 

A.  Bones  of  the  skull,  ossa  cranii. 
a.  The  Azygos  bones,  in  the  central  line. 
Os  basilare,  the  foundation  bone,  consists  of: 

47.  1.  Os  occipitalis,  the  occipital  bone. 

Position :  at  the  posterior,  inferior  part  of  the  head,  immediately 
above  the  vertebral  column. 

Figure  :  a  shallow  shell  placed  vertically,  with  a  horizontal 
portion,  united  by  a  ring. 

Portions:  pars  occipitalis;  2 partt.  condyloidese;  p.  basilaris. 

Between  which,  for.  occ.  magnum. 

Junctions  :  with  six  bones  :  two  parietal,  above ;  two  temporal, 
laterally  and  below  ;  one  sphenoid,  before  ;  and  Atlas,  beneath. 

a.  Pars  occipitalis,  the  upright  shell ;  below,  passing  into  the  condyloid  por- 
tions, is  itself  limited  by  the  foramen  magnum,  and  united  above  to  the  parietal 
bones,  sut.  lambdoidalis,  below,  to  the  mastoid  portions  of  the  temporal  bones, 
additamentum  sut.  lamb. 

1.  The  external  or  posterior  surface;  convex,  presents,  extending  from  the 
foramen  magnum  upwards,  the  crista  and  spina  occipitalis  externa  (for  the  Kg. 
NuchtE) ;  laterally,  from  the  crest,  the  linea  semicircularis  inferior  (for  the  muse, 
rectus  capitis  post,  may.,  obliquus  sup.),  and  superior  (for  the  m.  occipital,  et  tra- 
peziits"). 

2.  The  internal,  anterior  surface;  concave;  divided  into  four  fossae,  two 
superior,  fosses  cerebri;  two  inferior,  fossa  cerebelli.     In  the  centre,  the  protube- 
rantia  (spina),  interna  sen  cruciata(ibi  torcula  Herophili) ;  perpendicular;  crista 
inter na  (for  falx  cerebelli^  to  the  foramen  magnum;  horizontal:  linea  transversee 
(for  tentorium  cerebelli),  with  the  sulcus  transversus  (for  the  sinus  transversus). — 
Above  the  protuberance  ascends  the  sulcus  longitudinalis  superior,  generally  on 
the  right  side. 

b.  Paries  condyloidetz,  articular  portions ;  on  either  side  of  the  for.  magnum 
anteriorly. 

1.  Inferior  surface;  convex,  elliptical,  smooth;  rests  upon  the  processus  obliq. 
super,  of  the  Jltlas.     Behind,  the  condylus.  fossa  condyloidea  post.,  frequently 
perforated  by  the  for.  poster,  for  an  emissar.  Santorini;  laterally ;  fossa  cond.  ant. 
with  the  foram.  cond.  ant.,  (for  the  lingual  or  hypoglossal  nerve);  externally; 
the  processus,  (for  the  rect.  capt.  laieralis  muse.),  and  incisura  jugularis,  which 
forms  with  the  petrous  bone — the  for.  jugulare,  the  opening  for  the  commence- 
ment of  the  jugular  vein. 

2.  Superior,  cerebral  surface;  concave;  exhibits  the  processus  anonymus; 
foram.  condyl.  ant.  et  post.,  their  internal  openings;  and  a  part  of  the  sulcus 
transversus. 

c.  Pars  basilaris,  base  or  cuneiform  process;  azygos,  in  the  centre  before  the 
for.  magnum,  behind  the  sphenoid  bone  and  united  with  these. 


48  SPECIAL  ANATOMY. 

1.  Inferior  surface,  slightly  ascending  forwards,  rough  (for  attachments  of 
muse.  red.  cap.  ant.  major  et  minor),  forms  the  bony  roof  of  the  pharynx;  pre- 
sents the  spina  basilaris  seu  pharyngea  (for  the  m.  constrict,  pharyng.  superior). 

2.  Superior    surface,  ascends  obliquely  forwards  and  upwards;    smooth; 
forms  fossa  basilaris,  for  medulla  oblongata ;  at  the  sides,  narrow  grooves  for  the 
sinus  petrosi  inferiora. 

3.  Anterior  surface,  joins  with  the  sphenoid  bone ;  the  posterior  sharp  sur- 
face forms  the  anterior  boundary  of  the  for.  magn.  /  the  lateral  borders  are  in 
contact  with  the  petrous  bone. 

Borders  and  Angles.  The  two  superior  borders  form,  with  the  posterior  of 
the  Parietal  bones,  the  Lambdoidal  suture ;  instead  of  the  obtuse  angles  in 
which  they  unite,  in  the  new-born  child  we  find  the  lesser  fontanelle,  fonliculus 
triangularis ;  in  the  place  where  the  Occipital,  Parietal,  and  Mastoid  portion  of 
temporal  meet  together  the  posterior  lateral  Fontanelle,  later  the  ossa  Worm- 
iana;  generally  about  one  inch  lower,  the  for.  masloideum  (for  emissar.  San- 
torini). 

Texture.  The  internal  osseous  table  is  very  fragile,  particu- 
larly thin  and  translucent  at  the  inferior  part  in  ihefossze  cerebelli. 
In  the  condyloid  and  basilar  portions  the  spongy  tissue  predomi- 
nates. 

Development.  Four  points  of  ossification;  one  for  the  shell, 
which  appears  first;  two  for  the  articular,  one  for  the  basilar 
portion. 

Foramen  magnum  occipitale,  the  great  occipital  foramen, 
serves  for  the  passage  of  the  spinal  cord  with  its  membranes,  the 
vertebral  and  spinal  arteries,  and  the  accessory  nerves  of  Willis. 

48.  2.  Os  Sphenoideum,  sphenoid  bone. 

Position :  in  the  anterior  and  middle  part  of  the  base  of  the 
skull. 

Figure:  irregular,  something  like  a  flying  bat;  formed  of  a 
central  portion,  body,  with  four  horizontal  large  and  small  wings, 
and  two  vertical  processes  directed  downwards. 

Junction:  with  all  the  cranial  bones,  and  with  the  following 
bones  of  the  face :  Vomer,  ossa  zygomatica,  palatina,  and 
maxillaria  superiora. 

A.  Body  the  most  central,  cuboid  portion,  containing  two  cavities  separated 
by  a  partition,  sinus  sphenoidales,  which  are  closed  in  front  by  two  triangular 
bones,  ossicula  seu  cornua  Bertini,  and  only  connected  by  one  small  opening 
with  the  posterior  Ethmoidal  cells.  The  body  presents  6  surfaces: 

a,.  Superior,  cerebral  surface,  Sella  turcica,  s.  equina,  s.  ephippium,  Turkish 
saddle.     From  before  to  behind: 

1.  A  slight  depression  for  the  Nerv.  Olfactorii. 

2.  A  transverse  groove  leading  to  the  foramina  Optica,  (for  the  Chiasma  or 
commissura  Nerv.  Optica.) 

3.  A  four-sided  fossa,  fossa  pituitaria  (for  the  Hypophysis  cerebri),  properly  the 
sella  turcica. 

4.  Process,  chnoidd  medii,  on  the  anterior,  posteriores,  on  the  posterior  border  of 
the  saddle.     • 


THE  BONES.  49 

5.  Clivits.  the  back  of  the  posterior  border  of  the  saddle  (for  POTM-  Varolti}. 

(3  2  lateral  surfaces,  with  Sulcus  Caroticus  (for  the  internal  carotid 
artery) ;  Alae  Magnae. 

y.  Anterior,  with  crista  sphenoidal  (for  the  lamina  perpendic.  of  the 
Ethmoid  bone). 

J.  Inferior,  with  rostrum  sphenaidak  (for  the  Vomer),  and  commence- 
ment of  the  canal,  pterygopalatinus. 

i.  Posterior,  unites  with  pars  basilar.  occipit. — orifice  of  Vidian  canal. 

b.  Small   wings,  alee  parwe  s.  Processus  ensiformes,  triangular,   flat,   narrow, 
transverse  processes  springing  from  the  anterior  superior  surfaces  of  the 
body  with  two  roots.     Connected  with  pars  orbitalis  ossis  frontis. 
Superior  surface  is  covered  by  the  termination  of  the  anterior  cerebral  lobe. 
Posterior  border  separates  the  anterior  lateral  cranial  fossa  from  the  mid- 
dle. 

Processus  cKnoid.  anter.:  foramen  opticum  (for  the  optic  nerve  and  ophthalmic 

artery). 
Fixsura  orbitalis  superior,  the  fissure  between  the  great  and  small  wings 

(for  the  nerv.  oculomotor,  trochlearis,  ophthabnicus,  abducens,  and  for  the 

Vena  ophthalmica  cerebralis  a.n.dfacialis'). 

c.  Great  wings,  alee  magnet,  quadrangular,  broad  processes  projecting  from  the 

sides  of  the  body,  with  three  surfaces  and  borders. 
Surfaces: 

1.  Internal,  superficies  cerebralis,  concave,  forms  with  the  temporal  bone  the 
centre  fossa  of  the  Basis  Cranii.     From  before  to  behind  we  see ;  foram.  ro- 
iundum  (for  nerv.  maxillar.  sup.),  for.  ovak  (for  nerv.  maxillar.  inf.),  for.  spino- 
sum, (for  art.  meningea  media.) 

2.  External,  superficies  temporaRs,  divided  by  a  transverse  crest  into  two  por- 
tions, a  superior,  the  temporal  fossa  (for  the  muse,  temporalis),  and  an  inferior, 

fossa  zygomatica  (for  the  muse,  pterygoideus  extern-US').  On  the  last  the  inferior 
opening  of  the  foram.  ovale  and  spinosum;  Process,  spinosus  s.  spina  angularis 
(for  m.  malleus  ext.). 

3.  Anterior,  superf.  orbitalis,  a  quadrangular  plate,  forms  the  largest  portion 
of  the  external  wall  of  the  orbit.     The  superior  edge  unites  with  the  frontal 
bone ;  between  the  inferior  border  and  the  upper  jaw — the  fissura  orbital 
inferior  (for  Ven.  ophthalmica  facial.,  nerv.  infra-orbital  and  subcutaneous  maJce). 

Borders. — The  three  surfaces  meet  together  in  a  superior  broad  margin, 
which  unites  with  the  frontal  bone.  The  orbital  and  cerebral  surfaces  unite 
in  a  sharp,  free,  internal  border,  which  assists  in  forming  the  fissura  orbital 
super.  The  orbital  and  temporal  surfaces  in  the  anterior  superior  which  joins 
with  the  malar  bone,  and  in  the  anterior  inferior  which,  free  and  sharp, 
assists  in  forming  the  fissura  orbital,  infer.  The  temporal  and  cerebral  sur- 
faces form  the  posterior  superior  border  which  unites  with  the  squamous  por- 
tion of  the  temporal  bone,  and  the  oblique  posterior  inferior  border  which  ter- 
minates with  the  spina  angularis  behind  the  foram.  spinosum. 

d.  Processus  Pterygoidei,  palatine  wings,  descend  perpendicularly  from  the 
body,  one  on  either  side,  lying  in  the  upper  half  free  behind,  and  in  the  in- 
ferior close  to  the  upper  jaw  and  palate  bones.  Above  in  their  root  the  hori- 
zontal Canalis  Vidianus.  On  the  anterior  convex  surface  a  furrow  (sulcus 
pterygoideus),  which  forms,  with  one  upon  the  Palate  bone,  the  Canal  pterugo 
palatinus.  The  posterior  surface  concave  bounded  by  two  wings ;  jSla  externa 
(for  the  muscle  pterygoideus  ext emus'),  Ala  inter  na  with  a  hook,  hamulus  pteryg. 
(for  the  circumflexus  palati  mollis).  Between  the  wings,  above  the  ossa  pteryg. 

4 


50  SPECIAL  ANATOMY. 

{for  the  muse,  pteryg.  intern.'),  below  the  Incisura  pteryg.  (for  the  reception  of 
the  processus  pyramidalis  of  the  palate  bones).  Sometimes  there  is  a  sinus 
pteryg.  where  the  ala  extern,  and  internet  meet  together  with  the  Corpus  sphenoid., 
and  it  is  connected  with  the  Simts  sphenoidal.  (Mayer.) 

Foramen  pterygo-spinosum  (seu  interruptum,  Fitsebeck)  is  formed  by  a 
lamella  of  bone,  or  a  ligament  between  the  proc.  spinos.  alee  magnte  and  the 
ala  externa  proc.  pteryg.  (for  the  ganglion  oticum  of  Arnold). 

Texture  of  the  Sphenoid.  The  compact  osseous  tissue  pre- 
dominates. The  cavities  in  the  commencement  consist  of  spongy 
bone,  which,  by  degrees,  is  absorbed. 

Development.  In  the  foetus  the  small  wings  and  a  portion  of 
the  body  are  separated,  even  up  to  the  ninth  month,  from  the  rest 
of  the  bone  (in  lower  animals  during  life,  the  anterior  and  posterior 
sphenoids). 

Eight  points  of  ossification.  Deposit  of  bone  first  commences 
in  the  large  wings  from  the  fortieth  to  the  forty-eighth  day.  The 
Cornua  Bertini  unite  with  the  body  of  the  sphenoid  about  the 
fifteenth  to  the  eighteenth  year,  the  basilar  portion  in  the  eighteenth 
to  the  twenty-fifth  year. 

49.      3.   Os  Ethmoideum,  s.  cribriforme,  sieve  bone. 

Situation :  in  the  central  line  of  the  anterior  part  of  the  base  of 
the  skull,  before  the  sphenoid,  between  the  frontal  bones,  or  rather 
the  orbital  plates  of  the  frontal  bone,  and  behind  the  nasal  bones. 

Figure :  that  of  a  cube,  consisting  of  thin  bony  plates. 

Portions  :  1.  Central,  lamina  cribrosa  with  the  lamina  perpen- 
dicularis. 

2.  Lateral,  two  labyrinthi. 

1.  Lamina  cribrosa,  perforated  plate,  horizontal,  quadrangular. 

-  a.  Superior  surface,  looks  into  the  skull;  from  its  centre  a  narrow,  trian- 
gular process  ascends  perpendicularly,  the  Crista  Galli  (for  the  falx  cerebn), 
with  two  projections  on  its  anterior  border  (process,  a/ares);  here  is  the 
foramen-cacum.  On  the  sides  and  behind  the  crista,  the  numerous  foramina 
cribrosa  (for  the  nerves  of  smell);  a  groove  on  either  side,  sulcus  pro  nerv. 
olfactorio. 

b.  Inferior  surface,  the  uppermost  wall  of  the  nasal  cavity,  which  is  divided 
into  two  by  the  vertically  descending  lamina  perpendicularis.  The  vertical 
plate  anteriorly  lies  against  the  nasal  spine  of  the  frontal  bone  and  the  nasal 
bones ;  behind  upon  the  crista  sphenoidal.,  below  upon  the  Vorner  and  nasal 
cartilage. 

Borders:  a.  The  anterior  border  of  the  cribriform  plate  unites  with  the 
frontal  bone.. 

b.  The  posterior,  with  the  crista  sphenoidalis. 

2.  Labyrinthus,  the  lateral  portions  extend  directly  downwards  from  the 
cribriform  plate,  one  on  either  side  of  the  septum  nasi,  appear  externally  as 
a  thin  plate  (lamina  papyracea^  in  the  orbits,  internally  in  the  nasal  cavity 
(lamina  nasalis).    Between  the  two  plates  lie  the  cells  (sinus  Ethmoidaks). 


THE  BONES.  /  ^       51 

a.  The   papyraceous   plate,  bounded   above  by  the  frontal  bone,  indsura 
ethmoidaks  (foramina  orbitalia) ;  before  by  the  lacrymal  bones,  below  by  the 
upper  jaw,  behind  by  the  palate  and  sphenoid. 

b.  The  nasal  plate  is  divided  by  a  horizontal  fissure  into  a  superior  (poste- 
rior) shell  (concha  Morgagni),  and  a  central  (concha  media),  and  larger.     Both 
externally  concave.     Sometimes  there  are  three  shells  or  conchae. 

c.  Sinus  seu  cettula  ethmoidales,  with  a  transverse  septum  passing  through. 

a.  Anterior,  cell,   lachrymaks,  opening  with  the  frontal   sinuses,  below  the 
middle    concha   (Jnfundibulum,   meatus    nasalis   medvus).     Larger  and  more 
numerous  than 

b.  Posterior,  cell.  palatiruK;  opening,  with  the  sphenoidal  cells,  below  the 
superior  concha ;  they  are  separated  from  the  sphenoid  bone  by  the  Cornua 
Bertini.     The  cells  are  lined  with  a  delicate  periosteum  and  ciliated  epithe- 
lium, not  mucous  membrane. 

From  the  anterior  cells,  on  the  inferior  anterior  border  of  the  papyraceous 
plate,  a  hook  passes  off,  Process,  uncinatus,  which  unites  with  the  concha  in- 
ferior. 

Conjunctions  of  the  ethmoid  with  thirteen  bones : — frontal, 
sphenoid,  the  inferior  turbinate,  upper  jaw,  nasal,  lacrymal,  palate 
bones,  and  Vomer. 

Development.  Ossification  commences  at  the  fifth  month,  first  in  the  papy- 
raceous plates,  then  in  the  conchae ;  in  the  sixth  to  the  twelfth  month  after 
birth,  in  the  Crista  Galli  and  lamina  perpendicularis,  the  most  anterior  part  of 
which,  septum  mobile  of  the  nose,  remains  during  life  cartilaginous.  The 
cribriform  plate  is  first  completely  ossified  in  the  second  to  the  third  year, 
the  cells  are  first  developed  completely  in  the  fifth  to  the  sixth  year  ;  in  the 
mature  foetus  the  external  and  internal  lateral  walls  lie  close  to  one  another. 

50,  4.  Os  frontale,  s.  coronate,  forehead  bone. 

Situation.     At  the  most  anterior  part  of  the  skull  over  the  face. 

Shape  :  of  a  shell ;  the  superior,  larger  and  vaulted  portion,  p. 
frontalis,  vertical,  the  inferior,  paries  orbit  ales,  horizontal. 

Conjunctions  with  twelve  bones ;  two  parietal,  one  sphenoid, 
one  ethmoid,  two  nasal,  two  malar,  two  lacrymal,  two  superior 
maxillary  bones. 

a.  Pars  frontalis,  forming  the  forehead,  perpendicular  and  gently  vaulted, 
unites  at  its  superior  border  (m.  coronalis)  with  the  parietal  bones,  in  the 
coronal  suture ;  the  inferior  edge  limits  the  horizontal  part  anteriorly. — Two 
surfaces. 

1.  External,  convex,  with  the  frontal  suture  in  the  first  year,  a  frontal 
prominence,  tuber  frontak,  the  centre  of  ossification  on  either  side ;  under  this 
the  arch  of  the  eyebrow,  arcus  superciliares  (for  the  muse,  corrugator  supercilu)  ; 
between  them  the  triangular  smooth  surface  Glabetta,  and  below  them  mar- 
gines  supraorbitales,  superior  border  of  the  orbit  (for  the  m.  orbiculares  palpebra- 
rum),  with  Indsura  or  foramen  supraorbitale  (for  the  nerv.  art.  and  ven.  wpra- 
orbitaks),  and  externally  Process,  zygomaticus  (uniting  with  the  malar  bone), 
above  Crista  frontalis,  and  in  continuation  linea  semicircularis  (for  the  muse. 
temporalis~). 

2.  Internal,  concave  surface ;  besides  the  elevations  and  depressions  for  the 


52  SPECIAL  ANATOMY. 

convolutions  of  the  brain  and  the  Pacchionian  glands,  the  Suld  arteriosi  (for 
Arteria  meningea  anterior) ;  in  the  central  line  :  crista  frontalis  interna,  the 
commencement  of  the  sulcus  longitudinalis  (for  sinus  long,  superior),  and  foramen 
ccBcum,  a  blind,  sometimes  open  hole  (for  falx  cerebn). 

Conjunctions  :  above  with  the  Parietal  bones,  below  with  the  great  wings 
of  the  Sphenoid,  laterally  with  the  malar  bones. 

b.  Paries  orbitales,  orbital   portions,  horizontal,  the  superior  walls  of  the 
orbits,  separated  by  the  Incisura  ethmoidalis,  in  which  the  Ethmoid  lies. 

1.  Inferior   surface,   triangular,   concave,  in  the  orbit.     Towards  the  nose ; 
fossa  or  spina  trochkaris  (for  muse,  obliq.  superior)  •  externally  fovea  lacrymalis 

(for  the  lacrymal  gland). 

2.  Superior  surface,  convex,  uneven,  in  the  cranial  cavity,  supporting  the 
inferior  surface  of  the  anterior  cerebral  lobes. 

3.  Borders.     The  internal  forms  with  the  annexed  Ethmoid  bone,  foramina 
ethmoidalia  (for  Nerv.  Art.  et  Ven.  ethmoid?),  and  lies  anteriorly  upon  the  Lacry- 
mal bone  ;  the  external  unites  with  the  malar  bone,  laterally ;  with  the  great 
wing  of  the  Sphenoid,  behind. 

c.  Pars  nasalis,  nasal  portion,  short,  thick,  immediately  below  the  Glabella, 
between  the  orbital  portions,  beneath  excavated  in  a  horse-shoe  shape  into  an 
Incisura  nasalis  with  a  projecting  spine,  spina  nasalis  (for  the  nasal  bones  and 
upper  jaws),  on  the  sides  of  which  are  the  openings  of  the  frontal  cavities, 
sinus  frontales. 

The  frontal  sinuses,  only  completely  developed  after  the  age  of 
puberty,  lie  between  the  two  tables  of  the  frontal  portion,  from 
the  inferior  margin  of  which  they  ascend  to  the  frontal  eminences ; 
they  are  divided  by  a  septum  into  two,  sometimes  several  unequal 
spaces,  and  open  with  the  anterior  ethmoidal  cells  immediately 
below  the  middle  nasal  turbinate  bone.  They  are  lined  with 
periosteum  and  ciliated  epithelium. 

Development.  It  begins  in  the  second  month  of  foetal  life  with  two  lateral 
centres  of  ossification,  in  the  arcus  superciliaris,  which  in  the  first  year  are 
associated  by  a  suture  (sutura  frontalis),  which  for  some  years  continues  dimi- 
nishing. It  sometimes  exists  during  the  whole  life.  The  cavities  appear  in 
the  first  year,  and  by  degrees  enlarge  even  up  to  old  age. 

b.   The  cranial  bones  occurring  in  pairs. 
51.       5.   Ossa  parietalia,  s.  bregmatis,  vertex  bone. 

Two  quadrangular,  flat,  externally  convex,  internally  concave 
bones  ;  broader  before  than  behind ;  united  together  by  the.  sagit- 
tal suture;  forming  the  highest  part  of  the  cranial  vault;  one  on 
either  side  of  the  central  line,  two  surfaces,  four  borders,  four 
angles. 

Surfaces : — 

1.  External,  convex,  smooth,  vaulted  in  the  centre,  tuber  parietale,  the  centre 
of  ossification  ;  terminal  point  of  the  greatest  transverse  diameter ;  below 
this  the  linea  semicircularis,  the  concave  boundary  line  of  the  planum 
semicircularis,  which  is  above  convex  (for  the  muse.  temp,  and  fascia  tem- 
poral). 


THE  BONES.  53 

2.  Internal,  concave,  with  elevations  (juga  cerebralia).  impressiones  digit  at  a 
and  sulci  arteriosi  (for  the  arteria  meningea  media),  passing  from  the  inferior 
angle.  In  the  centre  fossa  parietalis. 

Borders : — 

1.  The  superior  mar  go  sagittate,  the  longest,  very  thick,  dentated;  presents 
upon  the  concave  surface  a  half  groove  which  forms  with  the  other  half 
groove  upon  its  fellow  bone  the  Sulcus  longitudinalis.     Foramen  parietale  (/. 
emissarium  Santorini). 

2.  The  inferior,  mar  go  squamosus,  the  shortest,   concave,    sharpened   off, 
unites  with  the  squamous  portion  of  the  temporal  bone  (Sut.  Squamosa). 

3.  The  anterior,  m.  corona/is,  toothed,  forms  with  the    frontal  bone   the 
coronal  suture. 

4.  The  posterior,  m.  lambdoideus,  long  indentations,  unites  with  the  occipital 
bone. 

Angles:  The  two  superior  are  right  (ang.  frontalis  and  ocdpitalis). 

The  anterior  inferior,  ang.  sphenoidalis,  pointed,  long,  with  the  sulc.  arte- 
riasus. 

The  posterior  inferior,  ang.  mastoideus,  obtuse,  with  sulcus  lateralis  s.  trans- 
verms  (for  the  transverse  sinus). 

The  two  parietal  bones  unite  anteriorly  in  an  extended,  poste- 
riorly in  a  right  angle. 

Conjunctions,  with:  os parietale, frontis,  occipitis,temporum, 
sphenoideum. 

Texture.  On  the  external  and  internal  surfaces,  compact,  bony  tissue, 
between  the  two,  diploe.  The  thickness  of  the  parietal  bones  diminishes 
from  above  to  below.  In  the  diploe  there  are  many  veins.  (Hence  danger 
from  fractures.) 

Development.  Ossification  commences  in  the  tuber  parietale,  at  first  in  the 
twelfth  week;  the  angles  are  developed  the  last  (hence  the  fontanelles). 

52.  6.  Ossa  temporum,  temple-bones. 

Situation:  one  on  either  side  of  the  skull,  below  the  parietal, 
before  the  occipital,  behind  the  sphenoid,  at  the  base  and  at  the 
sides  of  the  cranium. 

Shape:  irregular.  Parts  from  behind  forwards.  Mastoid,  squa- 
mous and  petrous  portions. 

Conjunctions  with  5:  3  cranial,  2  facial  bones,  parietal,  occipi- 
tal, sphenoid,  superior  and  inferior  maxillary  bones. 

I.  Pars  squamosa,  scale-like,  the  anterior,  superior,  shell-formed  portions  of 
the  bone,  the  thinnest  of  the  whole  cranium,  on  its  outer  side. 

a.  External  surface,  convex,  with  grooves  (for  Art.  temporal,  profund.),  and 
the  temporal  fossa  (for  muse,  temp.).  Processus  zygomaticus  s.  ansa  capitis  (for 
muse,  masseter),  forms  the  zygomatic  arch  with  the  process  of  the  (os  mala); 
between  its  two  roots,  the  cavitas  gknoidalis  (the  articular  cavity  for  the  head 
of  the  lower  jaw) ;  the  superior,  two-armed,  associated  with  the  inferior  in 
the  tuberculum  articulare  (for  the  ligam.  lateral,  extern.).  The  proper  anterior 
articular  cavity  is  separated  from  the  posterior  by  the  fissura  Glaseri  {Chorda 
tympani,  Muse,  malleus  externus,  Art.  et  Yen.  tympanica). 


54  SPECIAL  ANATOMY. 

b.  Internal  surface,  at  the  superior  part  a  distinct  horizontal  sulcus  arte- 
rialis. 

c.  Circumference.     Three-fourths  of  a  circle,  free,  above,  upright ;  the  in- 
ternal border  behind  cut  off  obliquely,  where  it  unites  with  the  cranial  bone; 
before  united  with  the  Sphenoid. 

2.  Pars  Mastoidea,  nipple-like  portion  behind  the  squamous,  and  deeper, 
separated  from  it  above  by  a  deep  .incision,  incisura  parietalis ;  below  by  the 
petrous  portion  (with  the  external  auditory  meatus).     In  the  thickness  of  the 
bone  are  placed  the  sinus  s.  cellules  mastoidece,  into  which  we  may  pass  from 
the  cavity  of  the  tympanum.     They  are  covered  with  delicate  periosteum  and 
pavement  epithelium,  not  mucous  membrane. 

a.  External  surface,  convex,  rough,  presents  below  and  before  the  proc. 
mastoideus   (for  the   muse,  sternocleido-mast.,  splenius   capitis,   retrahentes    auri- 
cula) ;   hence  inwards,  incisura   mastoidece  (for   the  muse,    digastricus) ;   still 
deeper  and  parallel  a  small  incision  (for  muse,  trachelo-mastoid.) ;  backwards, 
far.  mastoideum  (for  emissarium  Santorini),  and  sometimes  Jlrt.  meningea  pos- 
teriora. 

b.  Internal  surface,  concave,  with  the  broadest  portion  of  the  fossa  sig- 
moidea  (continuation  of  the  sulcus  transversus),  the  internal  opening  of  the 
for  am.  mastoideum. 

c.  Circumference  very  thick;  dentated;  anteriorly,  united  in  the  pointed 
Incisura  parietalia  with  the  parietal ;    behind,  thick  and  uneven,  with  the 
occipital  bone. 

3.  Pars  Petrosa,  s.  os  petrosum,    petrous   bone,   pyramidal,   trilateral,   lies 
obliquely  from  without  inwards  and  from  behind  forwards,  looking  with  the 
base  outwards,  with  the  apex  towards  the  cranial  cavity.     Very  solid,  but 
brittle ;  it  encloses  the  organ  of  hearing. 

a.  Basis,  between  proc.  zygomatic.  and  mastoid.  presents  Meatus  auditorius 
externus,  the  external  auditory  canal,  behind  the  cavit.  glenoidalis,  oval,  in  the 
centre  narrower  than  at  its  extremities  (in  the  fostus,  instead  of  it,  a  ring, 
annulus  tympani). 

b.  Apex,  obtuse,  the  exit  of  the   Canalis  caroticus  and  part  of  the  foram. 
lacerum  anterius;  externally,  tuba  Eustachii;   above  that,  canal,  tensoris  tym- 
pani. 

c.  Surfaces.     Inferior,  from  without  to  within;  Processus  styloideus,  twelve 
to  fifteen  lines  long,  sometimes  moveable,  always  in  animals;  backwards, 
foramen  stylo-mastoideum  (for  facial  nerve  and  stylo-mastoid  artery),  the  inferior 
opening  of  the   Canal.  Falkpice.     Inwards  from  the  styloid   process;  fossa 

Jugularis  (for  the  bulbus  Ven.  jugularis)  ;  the  anterior  half  of  the  for  am.  jugular. 
s.  lacerum  posterius  (for  the  Nervi  glossopharyngeus,  vagus  et  accessorius,  ram. 
jugularis  Nervi  sympathici  et  Vena  jugularis  interna),  with  the  Vallecula  s.  fos- 
sida  petrosa  (for  the  Ganglion  petrosum,  Nervi  glossopharyngei) ;  in  which  the 
inferior  opening  of  the  Can.  tympanicus ;  before  the  fossa  jugularis  the  en- 
trance to  the  Canalis  Caro'icus  (for  the  Carotis  interna  et  ramus  caroticus  nerv. 
sympathici) ;  [from  the  Carotid  Canal,  foramina  lead  into  the  Tympanum.^ 
Upon  the  septum,  between  fossa  jugularis  et  canal,  caroticus,  the  narrow  en- 
trance to  the  Jlquaductus  Cochlea. 

d.  Anterior  (internal)   surface.     This  is  the  posterior  wall  of  the  central 
cranial  fossa,  with  Hiatus  Canalis  Fallapia  (for  the  Nerv.    Vidianus  supcrfi- 
cialis)   in  the  centre;  anteriorly  and  externally  to  this  the  superior  opening 
of  the  canal,  tympanicus;  posteriorly,  eminentia  arcuata  of  the  superior  semi- 
circular canal  of  the  Labyrinth  of  the  ear.     A  groove  (for  the  sinus  petrosus 


THE  BONES.  55 

superior')  upon  the  upper  edge,  margo  petrosus ;   at   the   apex   a  semilunar 
depression  (for  the  gangl.  Gasseri). 

e.  Posterior  surface.     This  is  the  anterior  wall  of  the  posterior  cranial  fossa. 
Here,  we  see  the  Meatus  auditorius  internus  ;  it  is  short,  three  lines  long,  directed 
obliquely  forwards  and  outwards;  at  the  base  divided  by  two  cross  lines  into 
four  portions;  in  the  superior  anterior,  apertura  intern,  canal.  Fallopia  (for  nerv. 
facialis);  above  and  behind,  the  funnel-shaped,  fossa  vestibuli  superior;  below 
and  behind,  the  fossa  vestib.  inferior;  below  and  before,  fossa  cochlea;  these 
three,  with  their  lamina    cribrosce  (for  the  nerv.  acusticus  and  vasa  audit oria 
interna).     Immediately  above  the  meatus  a  fissure  or  blind  foramen  for  the 
reception  of  the  Dura  mater ;  an  eminence  of  the  inferior  semicircular  canal 
of  the  Labyrinth;  half  an  inch  posterior,  the  aquceductus  vestibuli  concealed 
behind  an  osseous  lamella. 

f.  Borders.     The  superior  (vide  d.)  ;  the  inferior  and  internal  extends  from 
the  apex  to  the  Incisura  parietalis,  where  it  blends  with  the  superior,  unites 
with  the  pars  basilaris  of  the  sphenoid  and  with  the  os  occipitis.     The  inferior 
external  lies  close  to  and  unites  with  the  great  wing  of  the  Sphenoid.     The 
anterior  and  free  border  forms  the  posterior  half  of  the  foram.  lacerum  anterius 
(which  is  an  interval  between  the  Petrous,  Sphenoid,  and  Occipital  bones 
filled  up  in  the  fresh  state  with  fibro-cartilage). 

Canalis  FallopitB  (for  the  nerv.  facialis'),  leads  from  the  internal  auditory 
meatus  over  the  Vestibule  transversely  outwards,  turns  (geniculuni)  at  the 
Hiatus  canalis  Fallopii  backwards,  passes  horizontally  over  the  fenestra  ovalis 
beneath  the  horizontal  semicircular  canal  to  the  posterior  wall  of  the  tym- 
panum, curves  itself  once  more,  and  descending  vertically,  makes  its  exit  at 
the  foram.  stylomastoideum.  With  the  tympanum  it  is  connected  by  the  canal, 
chord,  tympani,  by  the  canal  of  the  eminentia  papillaris  which,  like  the  canalic. 
mastoideus,  passes  oft'  from  the  vertical  portion. 

Canaliculus  Mastoideus  (for  ram.  auricularus  nerv.  Vagi)  commences  with  two 
small  openings  in  the  fissure  between  the  external  auditory  meatus  and  mas- 
toid  process,  and  terminates,  singly,  close  to  the  canal,  chorda  tymp.  in  the  canal. 
FallopieE. 

Canalis  tympanicus  (for  the  nerv.  tympanicus  of  the  gangl  petrosum)  runs  from 
the  vattecula  upon  the  floor  of  the  tympanum,  continues  as  a  groove  upon  the 
promontory,  and  again  opens  as  a  canal  between  can.  Fallopii  and  can.  tensor 
tympani,  close  to  the  hiatus  upon  the  anterior  surface  of  the  Petrous  bone. 

Development  Five  points  of  ossification ;  the  first  in  the  squamous  portion 
in  the  second  month  of  embryonic  existence;  the  second  in  the  pyramid;  the 
third  is  the  ring  around  the  tympanum,  annulus  tympani,  which  in  many 
animals  continues  as  a  distinct  bone  during  life,  in  the  embryo  lies  at  the  com- 
mencement almost  horizontally,  and  is  open  above;  the  fourth  in  the  mastoid 
portion;  the  fifth  in  the  Styloid  process.  The  zygoma,  at  birth,  is  little,  the 
external  auditory  canal  not  all  developed,  the  articular  cavity  therefore  almost 
flat;  the  mastoid  process  also  is  not  developed  until  late;  the  Labyrinth  and 
ossicula  auditus  are  completely  formed. 

53.  Of  the  Cranium  in  general. 

By  the  union  of  the  seven  bones,  now  described,  with  one  another 
by  means  of  peculiar  sutures,  a  tolerably  closed  shell  is  formed 
of  an  egg  shape  above,  but  somewhat  flattened  below  and  upon 
the  sides.  In  it  the  Brain  is  contained. 


56  SPECIAL  ANATOMY. 


54.  1.  Sutures,  Suturse  Cranii. 

In  a  newly  born  infant  a  suture  passes  in  the  central  line  of  the  skull  from 
the  superior  angle  of  the  occipital,  to  the  root  of  the  nose  on  the  frontal  bone. 
This  is 

1.  The  Sagittal,  s.  sagittalis,  between  the  Parietal  bones,  with  which  in  the 
adult, 

2.  The  frontal,  s.  frontalis,  unites. — This  long  suture  is  anteriorly,  upon  the 
crown  of  the  head,  crossed  by  a  transverse  suture,  the 

3.  Coronal,  s.  coronales,  wrhich  unites  the  parietal  with  the  frontal  bones, 
and  is  behind  bounded  by  the 

4.  Occipital,  s.   lambdoidea,  which  joins  the  parietal  and   occipital   tones 
together.     To  this  last  is  added  the  almost  rectangular 

5.  Mastoid  suture  [additamentum  suturce  lambdoidalis],  uniting  the  Occipital 
and  Parietal  bone,  a  portion  of  it,  with  the  mastoid  portion  of  the  temporal. 
From  this  (from  the  Incisura  parietalis),  anteriorly,  proceeds  the  arched 

6.  Squamous,  s.  squamosa,  between  the  parietal  and  squamous  portion  of  the 
temporal  bone.     Lastly,  below  the  frontal  bone  an  irregular  transverse  suture 
passes,  the 

7.  Transverse,  s.    transversa,  connecting   together   the   cranial   and   facial 
bones. 

These  sutures,  which  unite  the  edges  of  those  portions  of  the  bones  which 
become  ossified  at  a  later  period,  continue  incomplete  even  for  some  time 
after  birth,  and  therefore  present  at  the  angles,  where  most  of  the  borders  meet 
together,  unossified  intervals,  which  are  not  completely  closed  until  the  fourth 
year,  the 

55.  2.  Fontanelles,/onft'cw/i. 

In  the  middle  line  of  the  skull : — 

1.  Fonticulus  Major,  the  large  quadrangular  fontanelle  between  the  superior 
angles  of  the  Frontal  arid  Parietal  bones. 

2.  Fonticul.  Minor,  the  smaller  fontanelle,  triangular,  with  the  base  directed 
towards  the  occipital;  the  apex  towards  the  parietal  bones,  where  the  Lamb- 
doidal  impinges  upon  the  Sagittal  suture. 

On  either  side  of  the  skull  lies  a  fontanelle,  fontic.  lateral,  above  and  behind 
the  mastoid  .process  of  the  temporal  bone,  in  that  place  where  at  a  later  period 
the  parietal  meets  with  the  temporal  and  occipital  bones.  In  this  place  we 
frequently  meet  with  the  so-called  Wormian  bones,  ossa  triquetra;  the  number, 
size,  and  position  of  which  are  never  constant;  they  must  be  regarded  as  iso- 
lated, unessential  points  of  ossification.  Sometimes  a  triangular  bone  is  found 
at  the  superior  angle  of  the  lambdoidal  suture,  representing  even  the  apex  of 
the  occipital  bone  itself. 

56.  .  3.  Form  and  Measurement. 

The  shape  varies  with  the  Diameter  of  the  skull,  both  according  to  age, 
sex,  and  varieties  in  the  Race. 

1 .  Longitudinal  Diameter;  from  the  for.  cacum  to  the  occipital  protuberance  =  5 
inches. 

2.  Transverse  Diameter  between  the  bases  of  the  two  petrous  bones  =  4$ 
inches. 


THE  BONES.  57 

3.  Vertical  Diameter  from  the  anterior  border  of  the  for.  magnum  to  the  cen- 
tre of  the  s.  sagittalis  =  3^  inches. 

The  circumference  is  in  children  proportionably  greater  than  in  adults ;  in 
the  male  sex  and  in  the  Caucasian  Race  larger  than  in  the  female  and  other 
Races. 

The  circumference  of  the  skull  stands  in  an  inverse  relation  with  that  of 
the  face.  'Vide  the  facial  angle  of  Camper. 

57.  4.  The  Cranial  cavity,  cavum  cranii. 

a.  Basis ;  rests  upon  the  Atlas ;  contains  three  terrace-like  gently  descending 
fossae,  fossa  cranii. 

1.  Anterior,  most  elevated,  but  the  smallest,  supports  the  anterior  cerebral 
lobes,  is  formed  of: — 

Ethmoid,  Frontal,  and  the  lesser  wings  of  the  Sphenoid  bone : 

Presents,  anteriorly,  for.  caecum,  Crista  Gatti,  and  c.  frontalis  interna  (for  Falx 
cerebn). 

In  the  centre,  foramina  cribrosa  (for  olfactory  nerv-*)  :  posteriorly,  for.  Optica 
(for  Optic  nerve  and  Ophthalmic  artery')  •  Proc.  chnoid.  anter. 

The  sharp  posterior  border,  before  the  fossa  Sylvii  and  sinus  Ophthalmicus. 

2.  Central,  supporting  the  middle  cerebral  lobes  and  base  of  the  great  brain, 
formed  by  the  greater  wings  and  the  body  of  the  sphenoid,  by  the  squamous 
and  the  petrous  portions  of  the  temporal  bones:  posterior  limit:  Jlnguli  Petrosi 
and  the  posterior  edge  of  the  Sella  Turcica  : 

Presents,  in  the  centre,  the  Sella  turcica  (for  the  Hypophysis,  [pituitary 
gland],  Infundibnlum,  circular  sinus  of  Ridley :  with,  proc.  clinoid.  medii  (for 
the  commissure  of  the  Optic  nerve) ;  proc.  clinoid.  poster,  (for  the  corpora  mam- 
rnillaria) ;  next  the  sulcus  caroticus  (sinus  cavernos.,  carotis)  :  for.  lacerum  an- 
terius. 

At  the  sides,  anteriorly,  Fissura  orbitale  svperius  (for  nerv.  oculomotor,  troch- 
learis,  ram.  ophthalmic,  n.  trigemini,  n.  abducens,  ven.  ophthalmica). 

Farmer  backwards,  for.  rotundum  (for  nerv.  maxillar.  superior'). 

Externally,  for.  ovale  (for  n.  maxillar.  inferior^  • 

for.  spinosum  (for  art.  meningea  med.~) ;  and 
hiatus  canal  Fallopice,  and  for.  tynipanicum. 

3.  Posterior,  the  lowest,  but  largest  (for  the  cerebellum  and  MeduU.  Oblon- 
gata).  • 

Formed,  by  the  Petrous  and  Mastoid  portions  of  the  Temporal  bones  and 
by  the  Os  occipitis ; 

Bounded,  before  by  the  anguli  petrosi,  behind  by  the  sulcus  transversus : 
presents  in  the  middle  line,  anteriorly,  fossa  basilaris  (for  Pom  Varolii,  medulla 
oblongata)  ;  has  therein,  forarn.  magnum  (for  Spinal  cord  and  n.  access.  Wittisii, 
the  art.  spinal,  and  vertebral),  foram.  condyloidea  anteriora  (for  nerv.  Hypogloss.); 

Posteriorly,  spina  and  crista  occipit.  int.  (for  Falx  cerebetti,  torcula  Herophili); 

At  the  sides,  anteriorly,  for.  jitgiilare  (for  the  nerv.  glosso-pharyng.  vagus, 
accessorius  Will.,  and  venajugularis},  witli  the  termination  of  the  sulc.  trans- 
versus (for  sinus  transversus)  ; 

More  externally  and  above,  meat  us  auditorius  intern,  (for  nerv.  facialis  and 
acusficus,  and  Aquxduct.  Vestibuli)  • 

Lastly ;  linese  trantversae  (for  tentorium  Cerebelli),  with  sulcus  transversus. 

b.  The  Cranial  arch,  fornix,  the  smooth  roof  above  the  convex  surface  of 
the  brain ;  formed  of  frontal,  parietal,  and  occipital  bones. 


58  SPECIAL  ANATOMY. 

Presents,  in  the  central  line,  Salcus  longitudinalis  (for  the  longitudinal 
sinus),  extending  from  the  Spina  frontalis  internet  to  the  Eminentia  cruciata. 
On  the  sides  the  sulci  arteriosi  and  cerebral  impressions.  Here,  as  upon  the 
external  surface,  the  sutures,  already  mentioned,  may  be  seen.  The  brittle, 
hard,  bony  tissue  on  the  internal  surface  of  the  fornix  is  called  the  vitreous 
table,  lamina  vitrea. 

4.  External  surface  of  the  skull ;  it  is  covered  with  pericranium  (perios- 
teum) ;  presents  (the  sutures,  ut  sup.).  Besides  these: 

a.  Vault ;  linea  semicircularis,  one  upon  either  side,  from  the  central  frontal 
eminence  to  the  spina  occipital,  externa. 

Tubera  frontalia,  parietalia. 

b.  On  the  basis : 

1.  Anterior  half:  Pars  nasalis,  process,  or  bit  ales,  ocdpitales ; 

2.  Posterior  half:  Spina  and  Crist  a  occipit.  extern.,  Proc.  condyloid.,  Pars 
basilaris.     Lin.  semicircular,  inferior,  Occiput,  Fussa  cundyloid.  poster.,  Fora- 
men lacerum  posterius  s.  jugulare  ,•   Foramen  lacerunt  anleriufi,  with  Su/cus 
carotic.  and   Tuba  Eustackii,  to  which  point  all  the  sutures  of  the  posterior 
half  of  the  basis  Cranii  proceed. 

More  externally  and  posteriorly :  Proc.  mastoid.,  Proc.  styloid.,  For.  stylo- 
mastoid.,  and  the  inferior  opening  of  the  Canalis  caroticus. 

c.  At  the  sides :  the  mastoid  region,  foram.  mastoid.,  meatus  auditor,  ex- 
tern., cavitas  glenoidea,  root  of  the  Proc.  zygomatic.,  os  temp. 

Fossa  temporalis,  temporal  fossa,  is  the  name  given  to  the  space  between 
the  lateral  part  of  the  skull  and  the  zygoma,  which  below  passes  into  the 
zygomatic  fossa,  is  occupied  by  the  temporal  muscle  and  formed  by  the  tem- 
poral bone,  akt  magna  of  sphenoid,  malar,  superior  maxillary,  and  frontal 
bones,  and  bounded  below  by  the  zygomatic  arch ;  above,  by  the  I'm.  semicir- 
cular is. 

58.  B.   Ossafaciei,  Bones  of  the  face,  14. 

a.  Those  occurring  in  pairs. 

59.  1.   Ossa  maxillx  superioris,  2.  Upper  jaw-bones. 

Position :  anteriorly  in  the  face,  below  the  orbits. 
Shape :  irregular,  almost  cubical,  short;  Body  with  4  processes. 
Conjunctions  with:  Frontal,  Ethmoid,  and  Sphenoid  bones,  and 
with  all  the  bones  of  the  face  except  the  lower  jaw. 

1.  Body,  hollow,  bounded  by  four  surfaces.       , 

a.  Anterior,  facial  surface,  planum  faciale,  is  bounded  above  by :  Margo 
infraorbitalis,  the  inferior  border  of  the  orbit,  for  m.  orbicul.  palpebrarum  and 
levator  lab'd  superioris  ;  underneath  this,  foramen  infraorbitale  for  nerv.  art. 
and  ten.  infraorbitale ;  within  this  the  ant.  alveolar  foramen  for  ant.  dental 
nerve ;  and  fovea  maxillaris  s.  caninus,  for  m.  lev.  anguli  oris. 

b.  Posterior,  temporal  surface,  arched,  with:   Tuber  maxillare ;  foram.  al- 
veolar, poster.,  leading  to  a  canal  running  along  the  floor  of  the  antrum,  for 
nerv.  art.  and  ven.  alv.  post. 

c.  Superior;  orbital  surface  triangular,  with:  Sulcus  and   canalis  infraor- 
bitalis, for  nerv.  art.  and  ven.  infraorbitalis,  which  opens  upon  the  facial  sur- 


THE  BONES.  59 

face ;  margo  externus,  posterior,  free ;  between  it  and  the  larger  wings  of  the 
sphenoid  bone — -fissura  orb.  inferior. 

d.  Internal,  nasal  surface,  with  the  opening  of  the  antrum  Highmori,  before 
it  Crist  a  turbinalis  inferior,  for  the  inferior  concha  in  the  formation  of  the  lacry- 
mal  canal ;  sulcus  pterygo-palat.,  helping  to  form  canal,  ptery.-pal,  at  the  pos- 
terior part. 

Sinus  maxittaris  s.  antrum  Highmori,  pyramid-shaped,  with  very  thin  supe- 
rior, orbitar,  and  inferior  walls,  particularly  over  the  sockets  of  the  Canine 
and  first  Bicuspid  teeth,  connected  with  the  sin.  pterygoid.  and  jugal.  Its  ir- 
regular opening  contracted  by  the  inferior  nasal  concha,  Palate  and  Ethmoid 
bones  to  a  small  foramen  opening  beneath  the  inferior  turbinate  bone.  It  is 
lined  with  a  delicate  periosteum  and  ciliated  epithelium,  not  mucous  mem- 
brane. (Henle.) 

2.  Processes:  a.  Proc.  nasalis  s.  frontalis,  internal,  superior  process,  with  an 
external  surface,  for  m.  levator  lab.  super,  alceque  nasi;  and  an  internal,  con- 
cave, on  which  are  linece  turbinatce  s.  transverste,  for  the  middle  and  inferior 
nasal  concha ;  farther,  the  anterior  border  unites  with  the  nasal  bone,  the  pos- 
terior thick  border  with  a  groove,  sulcus  lacrymalis,  which  continues  into  the 
Canal,  lacrymal.  The  apex  lies  in  the  fissure  of  the  frontal  bone. 

b.  Proc.  zygomaticus,  external  superior  process  unites  with  the  malar  bone. 

c.  Proc.  alveolaris.  the  process  for  the  sockets  of  the  teeth,  that  is,  the  infe- 
rior thick  border  of  the  upper  jaw,  contains  eight  cells  for  teeth,  alveoli,  with 
projections  and  depressions ;  at  the  point  of  union  of  the  two  upper  jaws, 
Spina  nasalis  anterior ;  behind  that,  the  Canalis  incisivus,  for  the  nerv.  naso- 
palatin.  Scarpee,  and  arteria  sphenopalatin.,  leads  from  the  nasal  into  the  buccal 
cavity;  the foram.  incisivum  is  sometimes  double. 

d.  Proc.  palatinus,  palate  process ;  this,  the  horizontal  roof  of  the  mouth  and 
the  floor  of  the  nose,  unites  internally  with  the  palate  process  of  the  other 
side,  behind  with  the  horizontal  portion  of  the  palate  bone ;  thence  arise  the 
sutura  palatina  and  cruciata,  and  Crista  nasalis,  for  the  Vomer  upon  the  upper 
surface. 

Tissue  of  the  upper  jaw.  Spongy  substance  is  only  present 
in  the  alveolar  and  malar  processes.  The  entire  bone  is  very 
light. 

Development.  The  first  point  of  ossification  appears  from  the 
35th  to  the  55th  day  of  embryonic  existence  in  the  alveolar  pro- 
cess. A  centre  of  ossification  is  probably  found  in  the  position 
of  the  intermaxillary  bone  of  mammalia,  Os  incisivum  (Hare 
lip  an  arrest  of  the  development  of  this  bone) ;  likewise  one  for 
canal  is  infra-orbitalis. 

At  birth  the  upper  jaw  is  very  small;  nevertheless  the  antrum 
of  Highmore  is  already  present. 

60.  2.  Ossa  Palatina,  Palate  bones,  2. 

Situation,  at  the  posterior  part  of  the  nasal  cavity,  and  behind 
the  palate  processes  of  the  upper  jaw,  beforehand  in,  the  Ptery- 
goid processes  of  the  Sphenoid. 


60  SPECIAL  ANATOMY. 

Figure :  a  right  angle,  consisting  of  a  horizontal  palate  por- 
tion, and  a  narrow  vertical  plate. 

Conjunctions:  with  one  another  and  with  the  upper  jaws,  the 
sphenoid  bone,  the  inf.  Turbinate  and  the  Vomer. 

1.  Pars  horizontalis  ;  a.  Superior  surface,  which  forms  the  floor  of  the  nasal 
cavity,  with  the  Crista  nasalis  for  the  Vomer. 

b.  Inferior  surface,  which  forms  the  buccal  cavity ;  hard  palate,  with  spina 
nasalis  posterior,  for  m.  Icvatores  uvula.  The  internal  border  forms  the  sutura 
Palatina,  the  anterior,  sut.  cruciata. 

2.  Pars  ascendens,  thin,  quadrilateral,  longer   and  broader  than  the  plate 
before  described,  from  the  external  border  of  which  it  ascends  on  the  nasal 
wall  of  the  upper  jaw,  even  to  the  orbit. 

1.  Internal  surface  presents,  the  linea  transvers.  s.  crista  turbinalis  media  and 
inferior,  for  the  inferior  and  middle  turbinate  bones. 

2.  External  surface  lies  anteriorly  on  the  upper  jaw,  behind  on  the  pterygoid 
process;  presents  Sulcus  palatinus,  a  part  of  the   Canal  pterygo-palatinus,  for 
art.  and  nerv. 

3.  Processes  :  a.  Proc.  pyramidalis,  triangular,  external  and  posterior,  lies  in 
the  incisur  a  pterygoid.  of  the  Sphenoid.    On  it  two  canals;  Can.  palalinus  extern. 
and  intern,  between  fossa  spheno-maxittar.  and  palate,  for  nerv.  and  art.  palatin. — 
Above: 

b.  Proc.  orbitalis ;  triangular,  looks  with  its  superior  surface  into  the  orbit, 
lies  with  the  external,  behind  on  the  upper  jaw,  with  the  internal  on  the  pa- 
pyraceous plate  of  the  Ethmoid.     Behind  it,  inclining  backwards  : 

c.  Proc.  sphenoidaliSi  to  the  Body  and  the  cornua  of  the  sphenoid. 
Between  the  processes  b  and  c,  and  the  body  of  the  sphenoid,  the  Foram. 

sphenopalatinum,  for  the  nervi  nasales,  art.  et  ven.  spheno-palatina,  leads  from 
ihe  fossa  spkeno-maxillar  into  the  nose. 

Development.  The  first  osseous  nucleus  appears  about  the 
40th  to  the  50th  day  at  the  point  of  junction  of  the  processes. 
The  orbital  process  is  yet  wanting  at  birth. 

61.   3.  Ossa  Malaria  s.  jugalia,  s.  zygomatica,  Malar, 
Cheek  bones,  2. 

Situation :  at  the  superior  lateral  parts  of  the  face,  externally 
upon  the  upper  jaws. 

Shape  :  an  irregular  quadrangle,  consisting  of  a  body  and  three 
processes. 

Conjunctions  with:  Frontal,  sphenoid,  sup.  maxillary  and  tem- 
poral bones. 

1.  Body,  with  3  surfaces  and  3  borders;  contains  sometimes  a  cavity,  the 
size  of  a  bean,  sinus  jugalis  (Mayer),  especially  in  Mongolians  and  Malays, 
which  is  connected  with  the  Antrum  of  Highmore. 

a.  External,  facial  surface,  convex,  for  muse,  orbicularis  palpelrarurn^zygo- 
maticus  major  et  minor  ;  it  presents  foramen  zygomatic.  anlerius,  sometimes 
several ;  this  is  the  commencement  of  the  canal,  zygomat.  anter. 

b.  Internal,  orbital  surface;  this  is  the  anterior  part  of  the  orbit;  externally 


THE  BONES.  61 

it  presents,  for.  zygnmatic.  anter.,  which  is  the  end  of  the  Canal,  zygom. 
anter.,for  the  n.  subcutaneous  malae ;  a  groove  leading  to  fur.zygomat.  poster., 
the  commencement  of  the  Canal,  zygoma*  poster. 

c.  Posterior,  temporal  surface,  hollowed  out  for  muse,  temporalis,  presents 
the  end  of  the  canal,  zygomat.  poster.,  namely,  the  for.  zygomat.  poster,  for  the 
n.  zygomaticus  s.  temporalis. 

2.  Processes: 

a.  Pr.  frontalis,  the  superior,  unites  with  the  Frontal,  and  behind  with  the 
Sphenoid  bone. 

b.  Pr.  temporali*,  unites  with  the  process  of  the  temporal  bone  to  form  the 
zygomatic  arch  arcus  zygomaiicus,  for  the  muse,  masseter. 

c.  Pr.  maxillaris,  triangular,  broad,  and  little  projecting,  unites  with  the  Pr. 
zygomat.  of  the  upper  jaw. 

Formation.  The  malar  bone  consists  almost  entirely  of  com- 
pact bony  tissue  ;  spongy  tissue  is  only  found  at  the  anterior 
inferior  border. 

Development  begins  early  from  one  central  point  about  the 
50th  day  of  foetal  life.  At  birth  the  orbital  margin  is  sharp,  and 
it  is  not  rounded  until  later. 

62.  3.  Ossa  Nasalia,  Nasal  bones,  2 

Situation  :  next  to  one  another,  sometimes  united,  beneath  the 
frontal,  between  the  two  nasal  processes  of  the  sup.  maxillary 
bones ;  oblique  from  above  and  behind,  to  below  and  before. 

Shape :  a  long  quadrangle,  above,  narrow  and  thick,  below, 
broad  and  thin. 

Conjunctions:  with  Frontal,  Superior  Maxillary,  Ethmoid 
bones  and  Nasal  cartilages. 

1.  External,  cutaneous  surface,  covered  by  the  muse,  pyramidalis  nasi,  flat, 
somewhat  convex,  with  a  large,  and  several  smaller  foramina  for  the  Vasa 
nutritia. 

2.  Internal  surface,  the  anterior  portion  of  the  nasal  cavity,  presents  grooves 
for  vessels  and  nerves,  the  nerv.  Ethmoidalis. 

3.  Borders,     a.  Superior,  fitting   into  the  incisura  nasatis  of  the    Frontal 
bone. 

b.  Inferior,  supporting  the  lateral  cartilages  of  the  nose,  between  them  a 
foramen  for  a  nerve  filament  and  arterial  twig,  nerv.  Ethmoidalis. 

c.  Internal,  forms  with  the  bone  of  the  other  side  the  crista  nasalis,  for  the 
lamina  perpendicularis  of  the  Ethmoid,  and  above  for  the  spina  nasalis,  of  the 
Frontal  bone.  , 

d.  External,  longer  than  the  last  described,  unites  with  the  nasal  process  of 
the  upper  jaw  bone. 

Development :  from  one  osseous  centre,  commencing  at  the  end 
of  the  2d  month  of  foetal  life.  The  nasal  bones  are  completely 
formed  at  birth,  but  not  the  cartilages. 


62  SPECIAL  ANATOMY. 

63.  4.   Ossa  lacrymalia  s.  unguis, 

Lacrymal  bones,  2. 

Situation:  at  the  anterior  part  of  the  nn^al  wall  of  the  orbit, 
between  the  nasal  process  and  the  orbital  surface  of  the  superior 
maxillary  before  the  os  planum  of  the  Ethmoid,  beneath  the 
frontal  bone. 

Shape  :  quadrangular,  flat,  small,  like  a  finger-nail ;  translucent, 
thin. 

Conjunctions :  with  the  Superior  Maxillary,  the  Ethmoid, 
Frontal  and  Inferior  Turbinate  bones. 

1.  External,  orbital    surface,    divided    by   the  crista    lacrymalis   with    the 
hamulus  lacrymalis,  into  an  anterior  grooved  half,  which  forms  a  part  of  the 
fossa  lacrymalis  with  the  groove  on  the  proc.  nasalis  of  the  superior  maxilla, 
and  a  posterior  half. 

2.  Internal  surface,  presents  a  groove  which  forms  a  portion  of  the  middle 
nasal  chamber;  and  covers  behind  the  cellulte  ethmoidales  anterwres. 

Structure.  The  most  brittle  of  the  bones ;  consisting  of  com- 
pact substance. 

.Development.  One  osseous  centre  at  the  4th  month.  At 
birth  most  completely  formed. 

64.  5.   Ossa  Turbinata  s.  Conchss  inferiores, 

Inferior  Turbinate  bones,  2. 

Situation :  at  the  lowest  part,  on  the  external  wall  of  the  nasal 
cavity,  beneath  the  Ethmoid  bone. 

Figure:  twisted,  shell-like.     More  pointed  behind  than  before. 

Conjunctions:  with  the  Superior  Maxillary,  Palate,  Ethmoid 
and  Lacrymal  bones. 

1.  Internal  surface,  convex,  looks  towards  the  septum  of  the  nasal  cavity, 
and  sometimes  touches  it. 

2.  External  surface,  concave,  looks  towards  the  Superior  Maxillary  bone, 
arid  forms  a  portion  of  the  inferior  nasal  chamber. 

3.  Borders:  a.  The  superior,  unites  with  the  nasal  process  of  the  Sup. 
Maxillary  bone ;  behind  with  the  Palate  bone.     It  presents  from  before  to 
behind. 

1.  Proc.  lacrymalis,  united  at  the  apex  with  the  Lacrymal,  at  the  sides  with 
the  upper  jaw  bone;  forms,  with  the  proc.  nasal,  of  the  Sup.  Maxillary  bone, 
the  can.  lacrymalis. 

2.  Proc.  Maxillaris  s.  auricularis^   hooked,    contracts    the    opening  of  the 
Antrum  Highmori,  to  the  inferior  border  of  which  it  is  attached.     Behind  this 
a  small  border,  for  the  Palate  bone. 

3.  Proc.  Ethmoidalis,  unites  with  the  Proc.  iwcinnatus  of  the  Ethmoid. 

b.  The  Inferior  free  border,  in  the  centre  thicker  than  at  the  extremities,'  is 
more  or  less  distant  from  the  nasal  septum. 


THE  BONES.  63 

Structure  :  compact  bony  tissue,  but  porous  ;  many  canals  for 
nerves  and  veins. 

Development:  one  ossific  nucleus  in  the  centre,  about  the  5th 
month  after  birth. 

65.  b.  Azygos  Bones  of  the  Face. 
6.  Vomer,  Ploughshare  bone. 

Situation:  in  the  centre  of  the  nasal  cavity,  forming  the  poste- 
rior part  of  the  septum. 

Figure  :  flat,  angular.     Portions  :  2  surfaces,  4  borders. 

Conjunctions  with:  Sphenoid,  Ethmoid,  both  Superior  Max- 
illary and  Palate  bones,  and  the  cartilage  of  the  nasal  septum. 

1.  Surfaces,  with  small  grooves  for  vessels  and  nerves,  covered  with  mucous 
membrane. 

2.  Borders:  a.  Superior,  margo  sphenoidalis,  short,  thick,  with  a  deep  groove 
and  two  lips,  aUe  vomeris,  for  the  reception  of  the  rostrum  sphenoidale. 

b.  Inferior,  palatinus,  maxillary,  the  longest,  unites  with  the  arista  nasalis  of 
Sup.  Maxillary  and  Palate  bones. 

c.  Anterior,  m.  ethmoidaKs,  unites  with  the  lamina  perpendic.  of  the  Ethmoid, 
below  with  the  cartilage. 

d.  Posterior,  m.  gutturalis,  free,  thin,  sharp,  inclining  from  above  and  be- 
hind to  below  and  before,  separates  the  posterior  openings  of  the  nasal  cavity, 
choaruE. 

Structure  :  the  Vomer  consists  of  2  very  thin  plates  of  compact 
bone,  the  upper  separated  more  than  the  lower. 

Development:  begins  below,  with  the  3d  month  of  fetal  life, 
and  is  only  completed  in  the  12th  year.  Ossification  proceeds 
from  without  inwards,  so  that  for  a  long  time  a  groove  exists 
between  both  plates  for  the  reception  of  the  Sphenoid  and  Ethmoid 
bones. 

66.  7.  Maxilla  inferior,  Mandibula,  Inferior,  lower 

or  under  jaw. 

Situation  :  at  the  inferior  region  of  the  face. 
Shape  :   of  a  horse-shoe,  parabolic. 

Portions:  a  central  horizontal  body;  2  lateral  vertical  ascend- 
ing rami. 

Conjunction:  with  the  temporal  bones. 

1.  Body,  curved  like  an  arch,  consists  originally  of  two  pieces  of  bone 
which  unite  anteriorly  in  the  central  line,  to  form  an  arch,  the  chin,  mentum, 


vtm. 

NOTE.  In  many  animals  a  suture  exists  in  this  place  ;  in  Serpents  a  muve- 
able  articulation.  The  chin  of  animals  never  forms  an  arch,  but  always  an 
angle, 


64  SPECIAL  ANATOMY. 

a.  External  surface,  presents :  Spina  mentalis  externa.      To  the  outer  side  of 
this  foramen  mentale,  which  is  the  exit  from  the  Canal,  alveolaris,  for  Nerv.  Art. 
et  Ven.  alveol.  inferior. 

b.  Internal  surface,  presents:  in  the  centre,  Spina  mentalis  interna,  on 
either  side  processus  geni,  four  tubercles,  sometimes  surfaces,  the  two  superior 
for  the  genio  glossi,  the  two  inferior  for  the  Genio-Hyoidei  muscles,  and  a 
ridge  the  Mylo-hyoid  for  the  mylo-hyoideus  muscle ;  above  this  a  superficial 
fossa  corresponding  to  the  Sublingua/,  and  one  below  to  the  Submaxillary 
gland.     In  the  centre  also  a  nutritious  foramen. 

c.  Superior  border,  limbus  alveolaris  inferior,  behind,  thicker  than  before, 
presents :  sixteen  sockets,  alveoli,  for  sixteen  teeth  with  elevations,  Juga  alve- 
olaria,  for  the  levator  menti  and  indsivi  muscles. 

d.  Inferior  border,  base,  thick  with  an  anterior  lip  for  the  muse,  triangular., 
quadratus  menti  et  platysmamyoides,  and  two  posterior  surfaces  for  the  ante- 
rior bellies  of  the  m.  digaslricus. 

2.  Kami,  ascend  at  a  right  angle,  in  the  adult,  angulus  maxill.  infer.,  from 
the  body,  and  terminate  in  the  temporal  fossa  by  two  processes. 

a.  Surfaces.     1.  External,  flat,  rough,  for  muse,  masseter,  anterior  to  which, 
sometimes,  a  very  slight  groove,  for  art.  facial  is.     2.  Internal,  also  rough,  for 
m.  Pterygoid.  intern.,  with  foram.  maxillar.  poster.,  for  inferior  maxillary  or 
dental  nerve.   To  the  borders  of  the  foramen  is  attached  the  lig.  lateral,  intern., 
and  close  to  it  is  the  Sulcus  mylohyoideus,  for  the  nerv.  mylohyoid. 

b.  Borders:  posterior,  for  Parotid,  and  below  for  attachment  of  Stylo  max- 
illary ligament.     Anterior,  grooved ;  the  ridge  or  continuation  of  the  linea 
obliq.  extern,  et  intern. 

c.  Processes : 

1.  Anterior,  Proc.  coronoideus,  triangular,  the  apex  free,  for  muse.   Tem- 
poralis. 

2.  Posterior,  Proc.  condyloideus,  articular  process,  unites  in  the   Glenoid 
cavity  with  the  os  Temporum.     It  presents  the  neck,  Col/um  Condyli  and  the 
fossa  for  the  muse.  Pterygoid.  extern.     Between  the  two  processes :  Incisura 
semilunaris  seu  sigmoidea,  for  nerves  and  vessels. 

Structure.  Compact,  bony  tissue,  on  the  surfaces,  in  the  inte- 
rior Diploe.  The  canal  for  the  nerves  and  vessels  of  the  teeth 
follows  the  linea  obliq.  interna,  communicates  in  this  course  by 
one  foramen,  two,  with  the  alveoli,  divides  in  the  region  of  the 
Bicuspides  teeth  into  two  short  canals,  one  of  which  opens  at  the 
foram.  mentale,  the  other  passes  as  far  forwards  as  the  first 
incisor  tooth.  Lying  at  the  inferior  border,  before  the  appear- 
ance of  the  teeth,  they  are  associated  together,  and  the  canal,  alv. 
inf.  always  moves  upwards  as  age  advances,  or,  rather  bone  is 
developed  beneath  it,  and  thus  it  appears  to  ascend. 

Development.  Next  to  the  clavicle  the  earliest  perfectly  formed 
bone ;  in  mammals,  it  presents  even  in  the  2d  month  one  osseous 
centre  upon  either  side  for  the  body.  Soon  after  birth  the  two 
halves  unite  together.  In  the  new-born  infant  the  lower  jaw  is 
very  small,  the  angle  still  obtuse,  the  alveolar  processes  broad. 
In  old  age  the  alveolar  processes  disappearing  after  the  teeth  have 
fallen  out,  the  lower  jaw  becomes  smooth,  thick,  and  again  small. 


THE  BONES.  65 

67.  Appendage.  Os  Hyoideum,  s.  linguale,  tongue  bone. 

Position:  free  in  the  neck,  above  and  before,  between  the 
tongue  and  the  larynx,  horizontal. 

Shape  ;  a  Parabola  like  the  Greek  letter  upsilon  v. 

Conjunctions  ;  by  ligaments  with  the  temporal  bones  and  the 
thyroid  cartilage.  Parts :  1  body,  4  cornua. 

1.  Body,  basis,  the  horizontal,  anteriorly  convex,  central  portion,  is  upon  the 

a.  Anterior  surface,  divided  by  a  cruciform  projection,  a  trace  of  the  tongue 
bones  of  animals,  into  a  superior  and  inferior  half. 

b.  Posterior  surface,  excavated,  concave,  separated  by  fibrous  tissue  from  the 
epiglottis. 

c.  Inferior  border,  for  muse.  Hyo-thyreoideus. 

d.  Superior  border,  for  ligam.  suspensar.  lingua  and  lig.  flavum  s.  hyo-thy- 
reoideum. 

Terminations,  covered  with  cartilage,  for  the  reception  of  the  great  Cornua. 

Attachment  of  muscles;  to  the  Transverse  lines,  Mylo-hyoideus,  above  that 
genio-hyoideus  •  to  the  Superior  half:  digastricus,  hyoglossus,  stylo-hyoideus  •  to  the 
inferior  half;  sterno-hyoideus,  omo-hyoideus,  and  the  thyreo-hyoideus. 

2.  Great  Cornua,  longer  than  the  body,  ascend  from  before  backwards  and 
upwards,  for  Kerato-  (Hyo-)  glossus,  Kerato-pharyngeus  (part  of  middle  con- 
strictor) ;  capitulum,  for  ligam.  hyothyreoideum  laterale,  at  the  apex. 

3.  Lesser  Cornua,  or  corpuscula  triticea,  like  a  grain  of  wheat,  situated  ob- 
liquely upwards  and  outwards  at  the  point  of  junction  of  the  great  Cornua 
with  the  Body,  for  the  muse.  Chondro-glossus  (part  of  Hyo-glossus)  and  Chondro- 
pharyngeus  (a  portion  of  Constric.  Med.);  unites  with  the  Proc.  Styloideus  by 
the  ligam.  suspensorium,  sometimes  ossified;  it  is  connected  with  the  great 
cornua  and  the  body. 

Development:  proceeds  slowly  from  five  ossific  points,  from 
the  termination  of  foetal  life ;  it  commences  in  the  great  cornua. 

The  Cavities  of  the  Facial  region. 

68.  1.  Orbitae.     Orbital  cavities,  2. ;  for  the  organs  of  sight 

and  lacrymation. 

Figure :  an  obtuse,  quadrilateral  pyramid,  the  base  directed 
forwards  and  outwards,  the  apex  backwards  and  inwards ;  the 
axes  of  both  would  cross  behind  the  sella  turcica. 

1.  Base,  formed  by  four  borders,  with  four  angles,  Frontal,  Nasal,  Temporal, 
Malar. 

a.  Margo  supraorbitalis,  with  foram.  sometimes  Sulcus  supraorb.,  formed 
by  Frontal  bone; 

b.  M.  orbitalis  extemus,  with  foram.  zygomatic.,  by  malar  bone,  and  malar 
or  external  angular  process  of  frontal, • 

c.  M.  infraorbitalis,  with  for.  infraorbitale  and  anterior  dental  foramen,  by 
the  malar  and  sup.  Maxillary  bones  ; 

5 


66.  SPECIAL  ANATOMY. 

d.  M.  orbilalis  internus,  by  nasal  process  of  super.  Maxillary  and  internal 
angular  process  of  Frontal  bone ;  immediately  behind  is  the  little  Lacrymal 
bone.  The  circumference  is  narrower  than  the  cavity  behind  it. 

2.  The  Walls,  covered  with  periosteum,  Periorbita,  formed  of  seven  bones. 

a.  Superior,  the  roof,  formed  before  by  the  frontal,  behind  by  the  lesser 
wing  of  the  Sphenoid  bone,  presents:  an  external  angle,  fovea  lacrymal.,  for 
the  lacrymal  gland ,'  an  internal,  fovea,  s.  Spina  Trochlearis,  for  the  tendon  of 
the  tn.  obliq.  superior  ;  posteriorly,  the  suture  between  the  Frontal  and  Sphe- 
noid bones. 

b.  Inferior,  floor,  inclined  outwards  and  downwards,  formed  by  marg.  orbi- 
tale  of  the  malar,  fades  orbit,  of  the  upper  jaw,  and  behind  by  the  Proc.  orbi- 
tal, of  the  Palate  bone;  with,  Canal,  injraor  bit  alls ;  bounded  externally  by  the 
fismr.  orbital,  inferior. 

c.  External  wall,  formed  by  the  great  wing  of  the  Sphenoid  and  the  Malar 
bones,  with :  Fissura  orbit  ale  inferior  below,  fissura  orbit,  superior  behind,  and 
an  oblique  groove  upon  the  malar  bone  leading  to  the  superior  or  posterior 
malar  canal,  for  the  temporal  twigs  of  the  nerve. 

d.  Internal,  ibrmed  by  Lacrymal,  Ethmoid,  and  the  small  wing  of  the 
Sphenoid  bone.     On  this  wall  there  are  two  vertical  sutures ;  Fossa  lacry- 
malis,  and  entrance  to  the  Canalis  lacrymalis,  Foram.  Ethmoidalia,  Spina  s. 
fuvea  Trochlearis,  for  the  cartilaginous  loop  through  which  the  tendon  of  the 
W.  obliq.  superior  passes. 

3.  Apex,  above,  and  internal,  foramen  opticum;  below,  the  Fissura  supra 
and  infra  orbitalis  and  fossa  Spheno-maxillaris  meet  together. 

Connected  with:  1.  The  cranial  cavity,  by  the  foram.  opticum, 
Fissur.  orbital,  superior  and  foram.  ethmoid,  post. 

2.  The  nasal  cavity,  by  the  foram.  ethmoidalis  ant.  and  ca- 
nalis  lacrymalis. 

3.  The  Temporal  and  Pterygo-palatine  fossa  by  the  Jissur. 
orbital,  inferior  and  canalis  zygomat.  superior  s.  posterior. 

69.  2.   Cavitas  nasi,  nasal  cavity, 

consists  of  two  principal  cavities  lying  close  together,  and  sepa- 
rated by  a  septum  or  partition,  situated  between  and  below  the 
two  orbits,  and  bounded  above  by  the  horizontal  plate  of  the 
ethmoid ;  below,  by  the  united  superior  maxillary  and  palate 
bones,  open  before  and  behind,  and  covered  with  a  mucous  mem- 
brane, Membr.  Schneideri.  It  is  formed  of  fourteen  bones. 

1.  Anterior  opening,  pear-shaped,  Apertura  pyriformis,  formed  by  the  supe- 
rior maxillary,  and  nasal  bones,  which  have  attached  to  them  the  lateral  nasal 
cartilages. 

2.  Posterior  opening,   Choanas  narium,  quadrangular,  rather  longer  than 
broad,  divided  by  the  Vomer;   formed,  laterally,  by  the  Pterygoid  processes,- 
above  by  the  Sphenoid  and  Palate  bones;  below  by  the  Palate  bones;  looks 
towards  the  Pharynx. 

3.  Central  division,  septum  narium,  formed  by  the  vertical  plate  of  the 
Ethmoid,  by  the  Vomer,  crista  nasalis  of  the  Frontal,  crista  of  the  Nasal,  Sup. 


THE  BONES.  67 

maxillary,  and  Palate  bones,  with  the  continuation  of  the  cartilaginous  sep- 
tum Mobile,-  is  generally  curved  or  twisted;  forms  the  internal  wall. 

4.  Walls :  a.  superior,  concave,  formed  by  the  Nasal  bones,  the  nasal  spine 
of  the  os  frontis,  by  the  Ethmoid,  with  foramina  Cribrosa,  in  the  centre ;  by 
the  Sphenoid  behind. 

b.  Inferior  wall,  broader,  not  so  long,  posteriorly  deeper ;  formed  by  the 
Proc.  palatin.  of  the  Sup.  Max.,  and  the  horizontal  portion  of  the  Palate  bones ; 
presents,  canal,  incisivus. 

c.  External  wall,  very  irregular,  formed  by :  Ethmoid,  Lacrymal,  Palate, 
Sup.  Maxillary  and  the  Inf.  Turbinate  bones ;  presents  from  above  to  below. 

1.  The  superior  Turbinate  bone  or  Concha  ; 

2.  The  superior  nasal  chamber,  and  on  its  posterior  part  the 

3.  Foramen  spheno-palatinum,  and  the  openings  of  the  superior  Ethmoidal 
and  Sphenoidal  cells. 

4.  The  middle  Turbinate  bone  or  Concha,  and  middle  chamber  with  the 
opening  of  the  sin.  maxittaris,  and  the  anterior  Ethmoidal  and  frontal  cells. 

5.  The  inferior  Turbinate  bone  and  the  inferior  chamber,  with  the  open- 
ing 

6.  of  the  Canalis  Nasalis. 

Connection:  with  the  Frontal,  Ethmoid,  Sphenoid,  Superior 
Maxillary,  Orbital,  Buccal,  and  Cranial  cavities ;  the  last  by  the 
foramina  Cribrosa. 

70.  3.  Cavitas  oris;  Buccal  cavity,  mouth, 

formed  by  the  Superior  Maxillary,  and  Palate  bones,  the  Sphe- 
noid and  Inf.  Maxillary;  contains  the  tongue,  teeth,  glands,  and 
buccal  mucous  membrane. 

1.  Superior  wall,  palatal   vault,  palatum  durum;    formed  by:    the  Sup. 
Maxillary  bones,  proc.  palatini,  the   Palate  bones,  proc.  horizontal ;  and  Sphe- 
noid, proc.  Pterygoid;  presents  :  sutura  cruciata,  with  the  point,  where  5  bones 
meet  together,  namely,  2  Superior  Maxillary,  2  Palate  bones,  1  Vomer ;  fora- 
men Incisivum ;  the  openings  of  the  can.  pterygo-palatinus  and  the  2  Pala- 
tini; Sulcus  Palatinus  close  to  the  alveolar  border,  for  the  posterior  palatine 
nerves  and  vessels. 

2.  Anterior  and  lateral  walls ;  formed  by :  the  Alveolar  processes  with  the 
teeth  of  the  jaw  bones ;  presents :  on  lower  jaw,  Spina  mentalis  interna, 
proc.  geni,  for  muse,  genio-hyoidei  and  genio  glossi  ,•  linea  obliqua,  or  mylo- 
kyoidea,  under  this,  the  fovea  pro  gland,  submaxill.,  over  it,  fovea  pro  gland. 
sublingual. ,-  sulcus  mylo-hyoideus  and  foram.  maxillare  internum. 

Connections :  with  the  nasal  canal  by  the  can.  incisivus,  with 
fossa  spheno-maxillaris  by  canales  palatini. 

71.  4.  Malar  fossa,  fossa  zygomatica. 

Situation :  below  the  zygomatic  arch,  separated  from  the  fossa 
temporalis  by  the  crista  transversa  of  the  Sphenoid  bone. 
Formed  by :   Sphenoid,  Superior  and  inferior  maxillary  bones. 

1.  Superior  wall,  formed  by  the  inferior  surface  of  the  Ala  Magna  of  the 
Sphenoid  bone. 


68  SPECIAL  ANATOMY. 

2.  Anterior,  by  the  tuber  maxillar.  sup. 

3.  Internal,  by  the  ala  extern,  proc.  pterygoid. 

4.  External,  by  the  ram.  maxillaris  inferior. 

5.  Posterior  and  inferior  walls  are  deficient. 

On  either  side,  in  the  depth  between  the  Superior  maxillary,  pars  perpen- 
dicular, of  the  palate  and  proc.  pterygoideus  of  the  Sphenoid  bone,  belonging 
to  the  above  described  fossa,  is  situated,  the 

72.  Fossa  Spheno-maxillaris  s.  pterygo-palatina, 

the  Ptery go-palatine  fossa. 

Position:  behind  the  Orbital,  beneath  the  Cranial,  above  the 
Buccal,  close  to  the  Nasal  cavities ;  internal  to  the  fossa  zygo- 
matica.  Contains :  arteria  maxillaris  interna,  and  the  2d  division 
of  the  5th  nerve,  and  MeckeVs  Ganglion.  Five  foramina  lead  to 
this  fossa; 

a.  Above  and  behind :  foram.  rotunda  Vidianum,  pterygo-palatinum  / 

b.  Internally ;  foram.  spheno-palalinum  / 

c.  Below ;  the  superior  opening  of  the  Can.  palatin.  post. 

Connection  with:  the  orbit,  byjissur.  orb.  infer.;  the  nose, by 
for.  spheno-palat.;  the  mouth,  by  canal,  pterygo-palat.  and  pala- 
tini;  the  cranial  cavity,  by  foram.  rotund,  and  Vidianum. 

73.  Facial  angle. 

Angulus  fadalis  Camperi  is  formed,  by  drawing  a  perpendicular  line  from 
the  inferior  Incisor  teeth,  in  the  middle  line,  to  the  most  prominent  portion 
of  the  Frontal  bone,  and  an  oblique  from  the  same  place  to  the  external 
auditory  meatus.  It  measures  in  Europeans  80  to  85°,  in  Negroes  70°.  The 
more  pointed  the  angle  proves,  so  much  the  more  the  animal  conformation 
preponderates. 

74.  Vertebral  column,  back-bone,  columna,  s.  spina  verte- 

brarum  s.  rachis. 

Extends  from  close  beneath  the  cranium  as  low  down  as  the 
os  coccyx  which  forms  its  inferior  extremity;  contributes  to  form 
the  Thoracic,  Ventral,  and  Pelvic  cavities ;  is  gently  curved,  of  an 
undulating  figure,  and  contains  an  osseous  canal,  for  the  spinal 
marrow. 

Constituent  parts :  a.  True  vertebrae,  24 ;  Cervical  portion,  7 ; 
Thoracic  or  Dorsal,  12;  Abdominal  or  Lumbar,  5. 

b.  Sacrum,  5  false  vertebras  blended  together. 

c.  Coccygis,  4  false  vertebras  blended  together.     These  two 
together  form  the  Pelvic  portion. 

75.  1.  True  vertebras,  vertebras  verse. 

7  Cervical  vertebrae,  v.  cervicales ;  12  Thoracic  or  Dorsal,  v. 
dorsales;  5  Ventral  or  Lumbar,  v.  lumbales. 


THE  BONES. 


69 


Figure  :  ring-shaped.  Parts  :  Body,  Arches,  Processes  ;  1  Spi- 
nous,  2  Transverse,  4  Articular. 

Connection;  the  1st  cervical  vertebra  with  the  skull,  and  with 
the  2d  cervical  vertebra,  the  2d  with  the  3d,  and  so  forth  ;  the 
5th  Lumbar  vertebra  with  the  Sacrum ;  the  12  Dorsal,  besides, 
with  the  ribs. 

Position :  one  above  the  other. 

a.  Body,  corpus,  centrum,  is  the  anterior,  thickest,  and  most  essential  part  of  a 
vertebra ;  it  presents  above  and  below  slightly  concave  surfaces  covered  with 
cartilage,  for  its  junction  with  the  vertebral  body  lying  above  and  below  it, 
is  anteriorly  convex;  on  the  sides,  evenly  excavated  and  grooved;  behind, 
concave  and  perforated  by  foramina,  for  vessels.     This  posterior  surface  forms 
with  the 

b.  Arch,  crews  [neural  arch  (Owen)],  which  springs  from  its  posterior  lateral 
parts,  the  vertebral  foramen,  foram.  spinale  s.  medullare,  which  is  triangular  in 
almost  all  Vertebrae,  and  serves  as  a  passage  for  the  spinal  marrow.     The 
notches,  incisurce,  on  the  superior  and  inferior  borders  of  every  arch,  form,  the 
two  together,  an  inter  vertebral  foramen,  foram.  intervertebrale,  for  art.  and  nerv. 
spinal  upon  each  side. 

c.  Processes,  processus,  seven  in  number. 

1.  Muscular  processes,  proc.  musculares,  three  to  each  vertebra: 

a.  Processus  Spinosus,  one  Spinal  process  [Neural  spine,  (Owen)],  behind  in 
the  centre  of  the  arch;  its  root  almost  forked;  its  point,  apex,  freely  projecting 
into  the  back,  for  the  lig.  inierspinos.  apicum,  and  the  Extensor  muscles  of  the 
trunk. 

b.  Processus  transversi,  two  transverse  processes,  horizontal,  one  on  each 
side  between  the  body  and  arch  projecting  outwards,  for  lig.  intertransversalia,- 
and  the  obliquely  ascending  or  descending  cervical  and  dorsal  muscles. 

2.  Articular  processes,  proc.  articulares  s.  obliqui,two  superior,  two  inferior, 
spring  laterally  from  the  arch,  behind  the  transverse  processes,  project  out 
above  the  plane  of  the  vertebral  body ;  are  tipped  with  cartilage,  and  associated, 
the  two  of  the  one,  with  the  two  of  the  other  vertebra. 

76.     Differences  between  the  Vertebrae  of  the  three  regions. 


Cervical. 

Dorsal. 

Lumbar. 

Body 

Small,    insignificant  ; 

Larger,   higher;    su-j  As  large  again  as  the 

the     superior     sur- 

perior and  inferior)  cervical,  about  one- 

face    concave   from 

surface    flat,    heart- 

third    larger     than 

without    to   within. 

shaped;  upon  either 

the     dorsal  ;    supe- 

laterally    provided 

side  two  half  articu- 

rior surface  concave, 

with  elevated  mar- 

lar surfaces  for   the!   oval. 

gins,  which  fit  into 

head,    capitulum,  of) 

corresponding      de- 

the ribs;  on  the  ele-| 

pressions  upon  the 

venth    and   twelfth 

si  Jes  of  the  body  of 

one  whole  one  only. 

the  vertebra  imme- 

diately above;  infe- 

rior surface  slightly 

convex. 

70 


SPECIAL  ANATOMY. 


Cervical. 

Dorsal. 

Lumbar. 

Foramen 

One,  very  wide,  tri- 

Narrow,more wedge- 

Broad,  triangular. 

Spinale 

angular. 

shaped. 

Incisura  in- 

Superior  and  inferior. 

The  same. 

The  same. 

tervertebra- 

The  inferior  deeper 

lis 

than  the  superior. 

Proc.  spino- 

Short,  thick,  forked  at 

Long  ;    apex    blunt, 

On  the  sides  flat;  the 

sus 

the    point  ;    inferior 

tuberculous;  direct- 

apex expanded  into 

surface  grooved,  for 

ed  downwards,  and 

a  crescentic  enlarge- 

the vertebra  imme- 

overlaying one  an- 

ment ;       horizontal 

diately  below,  dur- 

other in  an    imbri- 

behind. 

ing     extension,    al- 

cated manner. 

most  horizontal. 

Proc.  obliqui 

Short,  oval,  flat;  the 

Small  ;    the   superior 

Strong  ;     quite     per- 

superior oblique,4  5° 

directed  backwards 

pendicular;  the  su- 

directed      upwards 

and   outwards,  the 

perior   concave    di- 

*. 

and  backwards,  the 

inferior  inwards  and 

rected  inwards  and 

inferior  downwards 

forwards  ;       almost 

backwards;  the  in- 

and forwards. 

perpendicular. 

ferior   convex    out- 

wards and  forwards. 

Proc.  trans- 

Broad;   at   the   base 

Stronger  ;        longer  ; 

Thin  ;    narrow  ;    flat 

versi 

perforated  byforam. 

horizontal;  directed 

from   before  to  be- 

vertebrate,   for    the 

backwards)     termi- 

hind; on  the  same 

art.      vert.,     above 

nating  roundly,  and 

plane  as   the  ribs; 

grooved,  for   the  v. 

with    an    articular 

hence,  proc.    costi- 

cervicales. 

fossa,  for  tuberculum 
costse. 

formis. 

The  most  particular  characters  by  which  to  recognize  the  different  vertebras, 
immediately,  are : 

1.  Cervical  vert. — Foram.  vertebrale;  the  extremity  of  the  proc.  Spinosus. 

2.  Dorsal  vert. — Articular  surface  upon  the  body,'  articular  fossa  on  the 
proc.  transversus. 

3.  Lumbar  vert. — The  want  of  those  characters   peculiar  to  the  cervical 
and  dorsal  vertebrae.     By  the  transverse  processes  we  can  most  easily 
distinguish  the  vertebrae  of  one  region  from  those  of  another. 

77.  Separate  Vertebrae. 

I.  Atlas,  first  cervical,  lies  like  a  ring  at  the  circumference  of  the  foramen 
Magnum,  close  to  the  skull,  which  it  supports;  consists  of  an  anterior  and  a 
posterior  segment.  Arcits  anterior,  in  the  place  of  the  vertebral  body,  is  flat, 
convex  anteriorly  with  a  tubercle,  tuberculum  anterius,  and  on  the  concave 
posterior  surface  provided  with  a  flat,  egg-shaped,  articular  fossa  for  the 
odontoid  process  of  the  second  cerv.  vertebra.  The  lateral  portions,  massse 
laterales,  are  strong,  present  above  the  concave  fossae  condyloidese,  correspond- 
ing to  the  superior  oblique  processes,  for  the  proc.  condi/loid.  occipitis ;  below 
the  round,  flat,  proc.  obliqui  inferioreti,  for  the  Epistropheus ;  upon  the  internal 
surfaces  of  either  side  a  tubercle,  tuberculum  laterule,  for  the  ligam.  trans- 
versum.  Arcus  posterior,  the  largest  part  of  the  Atlas,  consists  of  two  narrow 
plates,  which  meet  together  at  an  angle  and  terminate  with  the  tuberculum 


THE  BONES.  71 

postic.,  instead  of  the  proc.  spinosus. — Proc.  transversi  arise  from  the  lateral 
portions,  are  strong  and  provided  with  an  eminence,  for  the  oblique  muscles  of 
the  head. — Incisurce  vertebrales  lie  behind  the  proc.  obhqui,  are  deep,  and  form, 
almost  alone,  forcan.  intervert ebral. ;  the  superior, 'for  art.,ven.,  vertebral.,  and  n. 
cervical,  1.,  forms  with  the/oram.  vertebrale  a  canal,  often  closed,  which  is  at  the 
commencement  vertical,  then  perpendicular. — Foramen  spinale  wider  than  that 
of  the  other  vertebrae. 

II.  Epistropheufi,  axis,  dentatus,  the  second  cervical  vertebra,  is  particularly- 
distinguished  by  its  odontoid  process,  which  projects  six  lines  from  the  ante- 
rior superior  part  of  the  body;  it  has  a  broad  basis,  a  contracted  (brittle) 
portion,  collum,  and  the  extremity  terminates  in  a  tubercle,  apex,  for  the  Kg. 
odontoid.     Its  spinous  process  is  very  long  and  strong,  its  foram.  spinale  cordi- 
form  and  wide,  its  transverse  process  neither  grooved  nor  bifid,  the  vertebral 
foramen  passing  obliquely  outwards,  and  the  superior  articulating  surfaces 
are  nearly  horizontal. 

III.  Vertebra  prominens,  seventh  cervical. — The  spinous  process  projects 
strongly  backwards,  and  has  only  one  tubercle  at  the  apex. — Foram.  verte- 
brale, sometimes  wanting,  is  frequently  very  narrow.     On  the  body  there 
often  is  a  semiarticular  fossa,  for  the  first  rib. 

IV.  First  dorsal  vertebra. — On  the  body  the  projecting  lateral  borders  as  on 
the  cervical  vertebrae ;  besides,  one  whole  articular  surface  for  the  first  rib 
and  half  a  one  for  the  second  rib. 

V.  Eleventh  dorsal  vertebras.     A  complete  articular  fossa  for  the  eleventh 
rib ;  instead  of  the  transverse  process,  a  tubercle. — The  twelfth  dorsal  ver- 
tebra is  distinguished  from  the  eleventh  by  the  curved  surface  of  the  inferior 
articular  processes,  and  their  great  projection  in  a  vertical  direction,  down- 
wards. 

VI.  Fifth  lumbar  vertebra.     The  transverse  processes  are  much  larger  than 
those  of  the  rest  of  the  lumbar ;  the  inferior  articular  processes  are  more 
widely  separated,  look  directly  forwards,  are  flat,  not  convex. 

At  the  limits  of  any  two  regions,  the  characters  of  the  vertebra  more 
nearly  assimilate. 

78.  False  Vertebrae,  Vert,  spurise. 

There  are  nine  pieces,  which  in  the  adult  are  united  together 
into  two  bones. 

19.  1.  Os  Sacrum, 

originally  consisting  of  five  vertebras,  lies  at  the  posterior,  central 
part  of  the  Pelvis,  behind  its  point  of  junction  with  the  thigh 
bones  ;  above,  it  unites  with  the  last  lumbar  vertebra,  below  with 
the  coccyx,  right  and  left  with  the  hip  bones. 

Direction  :  oblique  from  before  to  behind,  and  from  above  to 
below,  forming  with  the  lumbar  vertebras  an  obtuse  angle,  Pro- 
montorium  s.  angul.  sacro-vertebralis. 

Figure :  a  quadrangular  pyramid  with  a  blunt  apex,  the  base 
above. 

Muscles:  glutaeus.  max.;  ilio-costalis,  s.  Sacro-lumbalis ; 
latissim.  dor  si  ;  pyriformis;  multifidus  spinse. 


72  SPECIAL  ANATOMY. 

Base  presents:  a  superior,  oval  articular  surface,  turned  towards  the  infe- 
rior surface  of  the  body  of  the  last  Lumbar  vertebra;  behind  this,  a  triangular 
opening,  formed  of  two  planes,  behind,  a  spinous  process;  two  triangular 
lateral  surfaces,  which  help  to  form  the  great  pelvis;  notches  to  form  the  last 
intervertebral  foramina;  two  superior  oblique  processes. 

Apex;  blunt,  with  a  transversely  lying  articular  surface  for  the  coccyx, 
behind  the  termination  of  the  sulcus  of  the  sacrum,  two  sacral  cornua,  which 
are  the  most  inferior  articular  processes. 

Surfaces : — 

a.  Anterior,  concave,  with    four  elevated  transverse  lines,   marking   the 
points  of  junction  of  the  vertebrae  spur.  ,•  on  either  side  four  anterior  sacral 
foramina,  for  nerves  and  vessels.     In  this  curvature  lies  the  Rectum,-  m. 
pyriformis  arises  external  to  and  between  these  foramina. 

b.  Posterior,  close  beneath  the  skin  in  the  centre,  convex;  in  the  middle 
line  the  Crista  Sacralis,  a  continuation  of  the  Spinous  processes,  which,  par- 
tially divided,  has  close  to  it,  laterally,  two  flat  furrows  and  four  foram.  sacral, 
post.,  for  the  nervi  sacr.  posterior.     Besides,  the  united  oblique  processes  pro- 
jecting more  strongly  outwards,  and  the  transverse  processes,  alas  sacral,  in  one 
piece. 

c.  Lateral  surfaces:  triangular,  above  broad,  below  narrow,  oblique  from 
before  to  behind,  and  from  without  inwards.     Anteriorly  a  semilunar  arti- 
cular surface,  fades  auricularis,  for  the  Hip  bone,-  behind  it  rough  elevations 
for  the  post,  sacro-iliac  ligaments.     Below  on  the  indented  borders  the  Sacro- 
Jschiatic  ligaments. 

Canalis  sacralis  is  the  termination  of  the  can.  spinalis  triangular,  above 
broad,  below  narrow,  and  terminating  in  a  groove.  Into  it  the  anterior  and 
posterior  sacral  foramina  open ;  out  of  it  the  Sacral  nerves  come  forth. 

80.  2.   Os  coccygis,  fundament,  tail  bone, 

consists  of  four  united  flat  tubercles,  the  size  of  which  diminishes 
downwards ;  is  flat,  triangular,  above,  broad  at  the  extremity  of 
the  Sacrum,  below,  pointed  and  free. 

Direction  :  usually  that  of  the  sacrum,  forming,  sometimes  with 
this  bone  a  right,  indeed,  even  an  acute  angle.  Important  in 
obstetricy. 

Muscles  :  glutseus  maxim.,  coccygeus,  levator  et  sphincter  ani. 

Basis,  the  most  superior  piece,  often  united  to  the  os  sacrum.  Behind  two 
cornua  stand  upwards  from  it;  externally  two  notches,  for  the  fifth  pair  of 
Sacral  nerves. 

Apex  sometimes  forked,  or  aside  from  the  middle  line.  For  the  levator 
Ani. 

Surfaces :  Anterior.     Before  it  lies  the  rectum. 

Posterior,  close  beneath  the  skin,  serves  for  the  attachment  of  the 

m.  glutseus  Max. 

Sides,  narrow,  indented,  rough,  for  Sacro-lschiatic  ligaments. 
Canalis  Spinalis,  Canal  for  the  Spinal  cord,  is  formed  by  the  foramina  spi- 
nalia  lying  over  one  another;  it  follows  all  the  curvatures  of  the  vertebral 
column,  the  diameters  of  which,  however,  differ  from  those  of  the  canal. 
Commencement:  at  the  great  Occipital  foramen. 
Termination:  in  the  sacrum. 


THE  BONES.  73 

The  largeness  of  the  canal  accommodates  itself  to  the  mobility  of  the  par- 
ticular regions  of  the  vertebral  column,  and  to  those  portions  of  the  spinal 
cord  whence  the  greatest  number  of  nerve  filaments  passes  off.  In  the  cervical 
and  lumbar  regions  the  column  is  most  moveable,  the  nerves  forming  the 
Brachial  and  Lumbar  plexuses  very  numerous,  the  canal  the  widest ;  in  the 
dorsal  and  pelvic  portions  the  reverse. 

The  anterior  wall  of  the  canal  is  formed  by  the  vertebral  bodies  lying 
close  over  one  another,  merely  separated  by  the  intervertebral  ligaments,  the 
posterior  by  the  vertebral  arches,  the  interspaces  between  which  are  closed 
by  short  extensible  ligamentous  masses,  ligament,  flava. 

On  both  sides  the  foram.  intervertebralia  open  into  it. 

Cdnnlis  vertebrulis,  vertebral  canal,  on  ekher  side  of  the  neck  is  formed  by 
the  over-lying  fftram.  vertebralia  of  the  tramverte  processes  ;  it  contains  arteria 
et  vena  vertebra/is. 

81.  The  Tissue  of  Vertebral  Bodies, 

consists  almost  entirely  of  spongy  substance  with  large  meshes,  covered  ex- 
ternally with  a  thin  layer  of  compact  tissue.  A  great  portion  of  the  processes, 
and  the  whole  of  the  arches,  consist  of  the  last  mentioned. 

The  vertebrae  are  very  richly  supplied  with  blood-vessels.  For  mis  pur- 
pose we  find  on  the  dorsal  surface  of  each  vertebral  body  a  horizontal  canal, 
which  divides  into  several  and  always  smaller  branches  in  the  spongy  sub- 
stance, all  of  which  are  lined  with  a  thin  layer  of  compact  bone  and  per- 
forated by  innumerable  smaller  foramina. 

82.  Development  of  the  Vertebral  Column. 

In  the  first  months  of  foetal  life  the  vertebral  column  forms  the  entire 
length  of  the  trunk,  at  birth  three-fifths,  and  in  the  adult  only  two-fifths  of 
the  length  of  the  body. 

In  the  first  period  of  development  the  curvatures  of  the  Vertebral  column 
are  wanting,  later  it  becomes  curved  in  the  form  of  a  wavy  line,  the  convex 
surface  in  the  neck  is  directed  forwards,  in  the  dorsal  region  backwards,  in 
the  lumbar  region,  again,  forwards,  and  in  the  pelvic  strongly  backwards. 
The  smallest  deviation  from  the  curvature  in  one  of  the  above  named  parts 
produces  corresponding  deviations  in  the  other  parts. 

Besides  these  there  exists  in  the  region  of  the  4th  and  5th  dorsal  vertebra1, 
in  the  region  of  the  Aortic  arch,  a  lateral  inclination ;  the  concavity  to  the  left, 
convexity  to  the  right. 

Abnormal  curvatures,  forwards,  backwards,  and  laterally  by  wasting  or  de- 
struction of  the  vertebrae,  or  by  inactivity  of  the  muscles  of  one  side  and  pre- 
ponderating activity  of  those  of  the  other,  occur. 

In  old  age  the  vertebral  column  curved  forwards  frequently  exhibits  a 
union  of  several  dorsal  or  lumbar  vertebrae. 

The  height  of  the  column  differs  according  to  age,  increasing  to  about  the 
twenty -fifth  year,  and  decreasing  upon  the  advance  of  old  age.  Its  average 
vertical  diameter  measures  2  feet  2  inches. 

The  separate  vertebrae  are  developed  from  three  centres  of  ossification,  at 
first  on  the  lateral  boundaries  of  the  spinal  canal,  as  a  defence  for  the  spinal 
cord,  and  vertebral  body.  Five  other  points  of  ossification  are  presented,  only 
later,  for  the  processes. 


74  SPECIAL  ANATOMY. 

Ossification  commences  with  the  fortieth  day  of  foetal  life  ;  a  year  after 
birth  the  two  lateral  portions  first  unite  together,  in  the  arch,  and  only  in  the 
third  to  the  fourth  year  with  the  body  ;  the  ossifying  points  of  the  transverse 
and  spinous  processes  are  first  united  in  the  twentieth  to  the  twenty-fifth 
year. 

In  the  Sacrum  and  Coccyx  ossification  commences,  first  in  the  body,  in  the 
second  to  the  third  month ;  the  junction  of  the  many  ossifying  points  takes 
place  very  late,  sometimes  not  at  all.  From  the  fortieth  to  the  sixtieth  year 
the  coccyx  usually  unites  with  the  Sacrum,  but  it  is  generally  more  slow  in 
females  than  in  males. 

83.  Thoracic  cavity,  chesty  thorax  s.  pectus. 

Situation :  between  the  seventh  cervical  and  first  lumbar  verte- 
brae, below  the  clavicle. 

Figure :  conical,  the  base  below,  the  obtuse  apex  turned  to- 
wards the  neck,  flat  from  before  to  behind. 

Parts:  1.  Dorsal  vertebrae,  vertebrae  dorsales,  twelve;  2. 
Breast  bone,  sternum;  3.  Ribs,  costse  s.  pleurse,  twenty-four. 

84.  I.   Sternum  s.  os  pectoris,  Breast  bone. 

Position  :  anterior,  central  part  of  the  chest. 

Shape:  flat,  sword-shaped,  above  broad,  one  and  a  half  to  two 
inches,  below,  narrow,  rounded;  before,  somewhat  convex;  be- 
hind, rather  concave.  Length,  from  five  and  a  half  to  seven  arid 
a  half  inches;  thickness,  above,  six  lines;  below,  three  lines. 

1.  Manubrium  Sterni,  handle,  the  most  superior  piece,  for  m.  sterno-hyoidei, 
— thyreoidei, — mastoidei. 

a.  The  superior  border,  concave,  called  incisura  semilunaris,  s.  Furcula 
(Vogel) ;  on  either  side  Incisura  cluvicularis,  an  oblong  articular  surface  for 
the  clavicle. 

b.  Lateral  borders,  longer;  with  FOVCSB  articulares  for  the  first  and  second 
ribs. 

c.  Inferior  limit,  a  transverse  line,  the  commencement  of  the  body,  where 
the  second  rib  attaches. 

2.  Corpus,  s.  Macro,  middle  piece,  for  m.  triangularis  and  pectoral,  major, 
the  longest  portion.     Fovese  articulares,  for  3  to  7  ribs.     Transverse  line. 

3.  Processes  ensiformis,  s.  xyphoides,  ensiform  process,  termination  of  the 
breast  bone,  for  m.  rectus  abdom.,  Diaphragm,  flat,  blunt  pointed  or  forked  at 
the  end,  generally  cartilaginous,  with  one,  sometimes  two  holes,  for  art.  mam- 
mar,  intern. 

Structure:  within,  spongy;  without,  compact  substance,  cov- 
ered with  membr.  propria  sterni. 

Development :  Ossification  commences  late  in  the  manubrium, 
about  the  fifth  to  the  sixth  foetal  month,  in  the  spaces  between 
the  extremities  of  the  ribs.  In  the  fifteenth  to  the  sixteenth  year 
there  are  five  to  six,  later  only  three  pieces  to  be  seen.  Ossicula 
episternalia,  according  to  Breschet,  rudimentary  ribs,  are  some- 


THE  BONES.  75 

times  present  at  the  superior  border  of  the  sternum,  one  upon 
either  side ;  they  are  generally  rather  larger  than  the  Pisiform 
bone. 

85.  II.   Costae,  Ribs,  twenty-four. 

Position :  between  the  vertebral  column  and  sternum ;  twelve 
upon  either  side. 

Figure :  flat,  narrow,  long,  thin,  elliptically  curved,  and  directed 
from  behind  forwards,  from  above  downwards. 

Breadth :  From  three  to  six  lines ;  thickness :  one  line. 

Division:  Costae  verae,  7;  Costx  spurias,  false  ribs,  5  upon 
either  side. 

Portions  of  each  rib :  Body,  posterior  and  anterior  termination. 

Connection  :  with  the  twelve  dorsal  vertebrae,  with  the  cartilages 
of  the  ribs  and  the  sternum,  with  the  last  bone  by  means  of  the 
cartilages  of  the  seven  superior,  or  true  ribs. 

1.  Posterior  extremity,  Head,  presents:  Capitulum  with  two  semi-articular 
surfaces,  uniting  with  bodies  of  the  dorsal  vertebrae,  from  the  second  to  the 
tenth  rib  between  the  two  vertebra?,  on  the  eleventh  and  twelfth  rib  in  the 
centre  of  the  body  [on  the  eleventh  above  the  centre].     Neck,  the  thinnest 
part  •  rough,  in  relation  with  the  transverse  proc.  of  the   vertebra  above  it ; 
Tuberculum,  tubercle,  the  infernal  portion,  for  the  transverse  process  of  the 
vertebra  below  /  the  external  for  ligaments ;  the  termination  of  the  neck  of 
the  rib. 

2.  Body,  central  portion,  with  the  Angulus  cosfae  not  far  from  the  Tubercle  ,- 
has  an  external  convex,  rough,  and  an  internal,  concave,  smooth  surface,  a 
thick  superior,  a  sharp  inferior  border.     On  the  last,  within :  Sulcus  costalis, 
for  the  art.,  ven.,  and  nerv.  intercostalis. 

3.  Anterior  extremity,  with  oval  articular  surfaces  [fossae]  for  the  cartilages ; 
at  the  last  an  obtuse  angle. 

The  true  ribs  unite  by  their  cartilages,  immediately,  with  the 
sternum  at  an  acute  angle  ;  increasing  in  length  from  above  to 
below. 

The  false  ribs,  c.  spurise,  five,  decrease  from  above  to  below  in 
length ;  as  well  as  their  cartilages. 

Particular  ribs.  1.  First  rib,  the  smallest  and  broadest,  with  short  and 
thick  cartilage  almost  immoveable.  The  external  surface ;  for  ven.  subclavia, 
before,  for  art.  subclavia,  behind — m.  scalenus  anterius  and  subclavius,  looks 
upwards,  the  superior  border  inwar'ds.  On  the  Capitulum  one  articular  sur- 
face ;  Collum,  long,  cylindrical ;  Tuberculum,  projecting,  angular ;  anterior 
extremity  broad. 

2.  Second  rib,  as  long  again  as  the  first,  may  lie  horizontal,  the  angle  very 
indistinct.     External  surface,  above,  for  m.  serratus  post,  sup.,  scalenus  med.  et 
post.     Internal  surface  obliquely  downwards,  with  a  very  superficial  groove. 

3.  Third  rib,  much  larger,  more  arched  below   and  before :  angle  more 
marked. 


76  SPECIAL  ANATOMY. 

4.  The  eleventh  and  twelfth  ribs,  Cusfas  fluctuant  es — very  moveable ; 
marked  curve.  Col/urn,  Tubercu/um,  et  Sulcus,  wanting.  On  the  Capitulum 
only  one  flat  articular  surface.  Anterior  extremity  very  thin  and  pointed. 
The  eleventh  is  longer. 

The  costal  cartilages  are  flat  like  the  ribs,  chiefly  formed  as  these,  and  ossi- 
fying easily  upon  the  surface.  They  are  twenty-four,  sometimes  twenty-six, 
or  only  twenty-two. 

The  external  extremity  lies  in  the  fossa  at  the  anterior  termination  of  the 
rib,  the  internal  is  either  immediately  united  with  the  Sternum,  in  the  true 
ribs,  or  with  the  inferior  border  of  the  rib  above,  as  the  eighth  to  the  tenth 
costal  cartilages,  or  extends  freely  into  the  abdominal  walls,  eleventh  to  the 
twelfth.  The  borders  of  the  fifth  to  the  seventh  ribs  are  united  together.  The 
three  superior  are  straight;  the  rest  curve  outwards.  Length:  the  first  rib 
is  very  short  and  thick,  often  ossified ;  the  following  to  the  seventh  always 
longer ;  from  the  eighth  to  the  twelfth  always  shorter ;  the  twelfth  only  a  few 
lines  long.  In  general,  the  length  of  the  cartilage  measures  one-fifth  of  that 
of  the  entire  rib. 

Structure  of  the  ribs :  it  is  similar  to  that  of  the  flat  bones  generally. 

Development:  Ossification  commences  with  the  second  month 
of  foetal  life,  from  the  body  outwards.  The  osseous  nuclei  in  the 
capitulum  and  tuberculum  appear  only  in  the  sixteenth  year,  and 
completely  united  in  the  twenty-fifth  year. 

86.  External  surfaces  of  the  Chest. 

1.  Anterior  region,  much  broader  below  than  above,  inclining  from  behind 
forwards,  from  above  downwards.     In  the  centre — sternum,  laterally  the 
costal  cartilages  with  the  intercostal  spaces;  externally  on  either  side  the 
linea  chondro-sternalis,  behind  this  the  limit,  namely  the  line  of  the  anterior 
angles. 

2.  Lateral  regions,  more  convex  behind  than  before,  presents  the  central 
piece  and  the  interspaces  of  the  ribs.     Intercostal  spaces  :  these  decrease  in 
breadth  from  above  downwards ;  however,  the  two  last  are  broader  than 
those  in  the  centre ;  and  the  space  between  the  anterior  is  broader  than  be- 
tween the  posterior  extremities  of  the  ribs. 

3.  Posterior  region,  between  the  posterior  angles.     In  the  centre :  12  Proc. 
spinosi  dorsal ;  close  to  these  the  sulci  vtrtebralis ;  12  Proc.  transversi ;  the 
articular  connections  with  the  tubercles. 

87.  Cavity  of  the  Chest,  Cavitas  thoracis. 

Anterior  wall ;  concave,  breast  bone  :  costal  cartilages.  Posterior  wall ;  in 
the  centre :  the  projecting  column  of  the  vertebral  bodies ;  at  the  excavated 
sides,  fossss  pulmonales,  for  the  convex  posterior  surfaces  of  the  lungs ;  pos- 
terior terminations  of  the  ribs. 

Lateral  parieties,  formed  by  the  ribs. 

Inferior  wall,  formed  by  the  diaphragm. 

Superior  wall  wanting;  in  place  of  it,  an  oblique  opening  inclining  from 
above  and  behind  downwards,  for  Trachea,  (Esophagus,  ductus  thoracicus, 
the  great  cervical  and  brachial  vessels,  nerv.  vagus  and  phrenicus,  the  apex  of 
the  lungs,  several  muscles. 


THE  BONES.  77 

The  arex  of  the  cavity  is  almost  immoveable ,•  the  rest  of  the  part,  and 
particularly  of  the  basis,  by  means  of  the  ribs,  very  moveable.  It  is  expanded 
in  inspiration,  contracted  during  expiration. 

In  the  foetus  are:  1.  The  diameters  from  before  to  behind 
greater  than  the  transverse  diameter,  the  Sternum  projects,  on 
account  of  the  size  of  the  heart  and  the  thymus  gland. 

2.  The  vertical  diameter  shorter,  since  the  diaphragm  projects 
high  upwards. 

3.  The  ribs   slightly  curved,  the  fossae  pulmonales  not  yet 
developed,  as  the  lungs  have  not  yet  respired. 

4.  The  inferior  opening  larger  in  all  directions,  on  account  of 
the  large  size  of  the  Liver. 

88.  The  Pelvis, 

formed  of— 1.  The  Sacrum  and  Coccyx  ; 

2.  The  hip,  or  unnamed  bones,  ossa  coxarum,  s.  innominata, 
two. 

It  lies  below  the  fifth  lumbar  vertebra,  at  the  side  and  before 
the  inferior  parts  of  the  vertebral  column ;  contains  a  portion  of 
the  intestinal  canal,  and  especially  the  organs  of  procreation  [with 
those  of  micturition]. 

89.  Os  coxae,  Hip  bones, 

occupy  the  anterior  sides  of  the  Pelvis,  are  flat,  and  consist,  be- 
fore the  age  of  puberty,  of  three  separate  bones, — the  Ilium, 
Ischium,  and  Pubes,  which  are  united  together  by  their  thickest 
parts  in  the  Acetabulum. 

Connection  :  behind  with  the  os  sacrum,  before  and  below 
with  each  other,  laterally  with  the  thigh  bones. 

90.  1.   Os  Ilium, 

is  the  largest  and  broadest  piece ;  the  most  superior,  and  forms 
the  lateral  wall  of  the  Pelvis ;  extends  from  the  Sacrum  to  the 
superior  third  of  the  Acetabulum : 

a.  External  surface;  undulating,  with  1  to  2   tineas  arcuatae  externa^  for 
glutaeus  medius  and  minimus;  and  a  few  foramina  for  vessels. 

b.  Internal   surface;  with    linea  arcuata   intema,  the  limit   between  the 
superior  part,  for  m.  Iliacus  internus,  which  is  the  lateral  wall  of  the  great 
pelvis,  and  the  inferior    portion,  that  of  the  lesser  pelvis.     Behind:  tuber 
Ilium  and  fades  auricularis,  the  articular  surface  for  the  Sacrum. 

c.  Crest  of  the  hip,  Crista  llii,  is  the  superior  S-shaped  border,  for  m. 
latissimus  dorsi,  and  quadraius  lumborum;  with,   1.  labiurn  exlernum,  for 
obliq.  externus;  2.  lab.  intemum,  for  m.  transvers.  abdom.;  3.  linea  interme- 
dia, for  m.  obliq.  internus. 

d.  Anterior  border,  descending  at  an  obtuse  angle  with  the  Spina  Ilei  ant. 


78  SPECIAL  ANATOMY. 

sup.,  for  m.  sartorivs,  tensor  fasciae  lotas,  and — inferior,  for  m.  rectus  femoris; 
between  the  two  spines  and  below  the  spina  inferior,  a  notch,  for  m.  lliacus, 
terminates  in  the  anterior  horizontal  ramus  of  the  pubes,  where  is  the  emi- 
nentia  ileo-pectinaea. 

e.  Posterior   border,  with  Spina  ilei  post.  sup.  /  inferior ;  Incisura  semi- 
lunaris. 

f.  Inferior  border,  from  the   Spina  poster,  infer.,  presents .  Incisura  ischia- 
dica  major,  for  m.  pyriformis,  art.  and  nerv.  glutseua,  iachiadicus,  and  pudend. 
communiy. 

91.  2.   Os  ischii,  seat  bone,  for  m.  levator  ani. 
The  most  inferior  portion  ;  below  and  behind  the  Ilium. 

a.  Corpus,  the  inferior  portion  of  the  acetabulum.    Internal  surface  smooth, 
forms  the  inferior  portion  of  the  small  pelvis.     Posterior  border  with  Spina 
ischii,  the  limit  between  Incisura  ischiadica  major  arid  minor,  for  m.  gemellus 
super.,  coccygeus  and  Ligam.  spinoso-sacrum.     Anterior  border,  commence- 
ment of  the  obturator  foramen. 

b.  Ramus  descendens,  short  and  thick.     Posterior  border  forms  the  Incisura 
ischiadica  minor,  for  m.  obturator  internus,  art.,  ven.,  nerv.  pudendus  commu- 
nis,  from  Spina  ischii  to  Tuber  ischii,  for  m.  geme/lus  infer.,  quadratus  femo~ 
ris,  semitendinosus,   semimembranosus,  biceps,  transversus  perinea/,   Ligam. 
tuoeroso-sacrum.    Anterior  border,  sharp,  assists  in  forming  obturator  foramen. 

c.  Ramus  ascendens — ascends  from  Tuber  ischii  forwards  and  inwards,  for 
m.  ischio-cavernosus.     Internal  border  forms  the  internal  part  of  the  obturator 
foramen.     External  border  a  part  of  the  Pubic  arch. 

92.  3.   Os  pubis  s.  pectinis, 
in  the  anterior  region  of  the  pelvis. 

a.  Corpus — the  inner  third  portion  of  the  acetabulum — with  Eminentia  ileo 
pectincea,  for  crural  artery  above  the  Acetabulum. 

b.  Ramus  horizontalis,  for  m.  red.  abdom.,  pyrarnidalis — above.     Superior 
border,  sharp,  Pecten  s.  Crista  pubis,  for  Pectinteus  m.,  a  continuation  of  line  a 
arcuata,  terminates  in  Spina  pubis,  for  ligam.  Pouparti.     Inferior  border,  the 
superior  part  of  the  obturator  foramen. 

c.  Ramus  descendens  for  m.  adduct.,  gracilis,  descends  from  the  Spina  pubis, 
to  meet  the  ram.  ascend,  of  the  Ischium.     External  border  forms  the  internal 
of  the  obturator  foramen;  internal  border,  with   that  of  the  other  side,  the 
pubic  symphysis,  over  this  angulus  pubis,  superior;  beneath    it  the    superior 
portion  of  the  pubic  arch. 

Acetabulum,  the  hemispherical,  hollow  surface,  in  which  the  body  of  the 
three  bony  pieces  meet  together,  lies  on  the  external  side  of  the  pelvis  ob- 
liquely oiitwards  and  downwardsj  and  is  destined  for  the  reception  of  the 
thigh  bones.  Its  crescentic,  sharp  edge,  supercilium,  has  below  and  internally 
a  deep  Incisura  acetabuli,  for  the  vessels  of  the  joint  to  enter,  and  is  still  more 
deepened  by  a  tendinous  ring,  labrum  cartilagineum.  Move  is  a  horizontal 
groove,  for  Undo  rectifemor.,  beneath  a  deeper,  for  tendo  obturator  externi.  The 
whole  external  surface  is  covered  with  cartilage,  that  is  the  fades  lunata,  to  the 
small  Fovea  for  the  attachment  of  the  ligam.  teres.  The  internal  surface 
turned  towards  the  small  pelvis  is  rather  curved  downwards  arid  backwards. 


THE  BONES.  79 

passing  to  the  spina  ischii.  Important  at  the  time  of  labour  on  account  of  the 
turning  of  the  foetal  head. 

The  Obturator  foramina,  2,  foramen  obturatorium,  s.  wait,  formed  by  the 
ischium  and  pubis,  lies  at  the  anterior  region  of  the  pelvis.  At  the  superior 
external  wall  a  groove,  for  art.,  ven.,  nerv.  obturatorius ;  otherwise  entirely 
closed  by  the  memb.  obturatoria.  External  boundary  for  the  m.  obtur.  extern.,- 
internal  for  m.  obtur.  intern. 

Symphysis  ossium  pubis,  in  the  central  line  of  the  body  at  the  anterior  re- 
gion of  the  Pelvis,  formed  by  the  internal  vertical  borders  of  the  two  ««a 
pubis,  15  to  20  lines  in  height,  higher  in  the  male  than  the  female.  The  arti- 
cular surfaces  are  oval,  flat,  but  directed  obliquely  from  behind  and  internally 
to  before  and  externally.  There  is  a  triangular  space,  with  the  apex  behind, 
between  them,  which  is  filled  with  an  elastic,  strong,  Ligamentum  interos- 
seum  pubis.  Besides  this,  three  ligamenta  pubica  serve  to  unite  the  pubes, 
the  most  important  of  which,  triangulare,  assists  in  forming  the  pubic  arch. 

The  Pubic  arch,  Arcus  pubis,  angular  in  the  male,  round  in  the  female,  is 
formed  by  the  ascending  rand  of  the  Ischia  on  either  side,  by  the  inferii/r 
lx>rder  of  the  Ram.  descend,  os  pubis,  and  the  ligam.  triangulare  s.  arcuatum. 
Superior  transverse  diameter  one  inch,  inferior  three  inches. 

The  Sacro- Iliac  symphysis  unites  the  ossa  innominata  behind  with  the 
sacrum,  superficies  auriculares,  making  a  double  angle,  first  vertical,  then  from 
behind  to  before.  This  articulation  is  also  moveable,  although  not  to  the 
same  extent  as  the  Symph.  pubis. 

93.  Cavity  of  the  Pelvis,  cavitas  pelvis, 

contains,  a  portion  of  the  small  intestines,  the  rectum,  the  urinary 
bladder,  the  internal  organs  of  generation,  vascular  and  nervous 
trunks. 

1.  Pelvis  major,  the  great  Pelvis;   open  before  and  behind, 
(closed  behind,  if  we  consider  with  the  Obstetricians,  that  the 
fifth  Lumbar  vertebra  forms  a  part  of  the  pelvis,)  formed  by  the 
alae,  of  the  Ilia,  fossae  iliacae,  for  m.  Iliacus  intern.,  and  the 
small  intestine;  is  below  narrower  where  the  linea  arcuata  di- 
vides it  from    the   small  pelvis.     Anterior  transverse  diameter 
between  the  Spinss  anter.  sup.     Eight  to  nine  inches. 

Linea  arcuata,  a  crescentic  raised  line,  passing  from  the  centre 
of  the  superior  border  of  the  Sacrum;  over  this,  the  Ilium  and 
the  os  pubis  to  the  anterior  spine  of  the  pubis. 

Promontorium — angle  of  the  fifth  lumbar  vertebra  with  the 
sacrum. 

2.  Pelvis  minor,  the  small  pelvis  at  the  superior  and  inferior 
outlet  narrower  than  in  the  centre. 

a.  Apertura  superior,  elliptical  or  oval,  with  three  diameters: 

1.  Straight  diam.,  conjugata  [antero-posterior]  =  4  inches,  from  Promon- 
tory to  superior  border  of  symphysis  pubis. 

2.  Transverse  diam.  =  5  inches  from  the  centre  of  the  linea  arcuata  of  the 
one  to  that  of  the  opposite  side. 

3.  Oblique  diam.,  Diam.  Deventeri,  two,  =  4£  inches  from  sacro-iliac  sym- 


80  SPECIAL  ANATOMY. 

physis  of  the  one  side  to  the  ileo-pectineal  eminence  at  the  superior  border  of 
the  Acetabulum  of  the  other. 

b.  Cavum  pelvis  minoris,  formed,  behind,  by  the  Sacrum  and  Coccyx,  the 
cavity  of  which  is  4  inches  6  lines,  and  depth  10  to  12  lines;  anteriorly  by  the 
si/mphysis  and  ossa  pubis  with  foram.  obturator,'  laterally  by  oss.  Ischii. 
Diameter. 

1.  Straight  diameter  [ant.  posterior]  =  4£  inches  from  the  centre  between 
the  second  and  third  pieces  of  the  Sacrum  to  the  Symphysis  pubis. 

2.  Transverse  diam.  =  4  inches  between  the  Spina  ischii,  before  and  above 
them. 

c.  Apertura  inferior,  pelvic  outlet,  formed  by  the  apex  of  the  coccyx,  the 
Tuber  Ischii,  and  Arcus  pubis,-  has  three  notches;  arcus  pubis  and  Incisurse 
ischiadicse. 

1 .  Straight  diam.  [ant.  post.]  =  3 £  to  4  inches  from  the  apex  of  the  coccyx 
to  the  crown  of  the  pubic  arch. 

2.  Transverse  diam.  =  4  inches  from  internal  border  of  one  Tuber  Ischii  to 
the  other. 

3.  Oblique  diam.,  two,  =  4  inches  from  the  centre  of  the  ligam.  sacro-ischi- 
adic  of  one  to  the  Tuber  Ischii  of  the  other  side. 

The  axis  of  the  small  pelvis,  that  is,  a  perpendicular  drawn  through  the 
centre  of  the  straight  diameter,  passes  above  obliquely  backwards,  below  ob- 
liquely forwards.  Inclination.  The  Promontory  lies  3^  to  4  inches  higher 
than  the  superior  border  of  the  Symphysis  pubis,  and  the  Conjugata  therefore 
makes  with  a  horizontal  line  an  angle  of  60°.  The  apex  of  coccyx  lies  ^  to 
1  inch  higher  than  the  inferior  border  of  the  Symphysis  pubis. 

Development  of  the  Bones  of  the  Pelvis. 

Ossification  commences  in  the  acetabulum,  first,  that  is,  in  the 
body  of  the  Ilium,  in  the  fourth  month  of  the  foetus.  At  the  age 
of  puberty  the  inferior  border  of  the  Ischium  and  the  crista  Illi 
first  ossify,  and  the  last  only  unites  with  the  rest  of  the  bone  at 
the  twentieth  to  the  twenty-fifth  year. 

In  young  children,  and  even  more  in  the  unborn,  the  pelvis  is 
relatively  much  more  narrow,  and  strongly  inclined,  so  that  the 
urinary  bladder  lies  with  its  whole  anterior  surface  on  the  abdo- 
minal parietes,  instead  of  in  the  lesser  pelvis.  Characters  of  the 
female  pelvis,  vide  109. 

Bones  of  the  Extremities,  Ossa  extremitatum. 

A.  Thoracic  extremities,  arms,  extremitates  superiores,  s.  tho- 
racicae,  Brachia. 

94.  I.  Shoulder,  Humerus, 

consists  of  the  shoulder-blade  and  collar-bone. 

1.  Scapula,  Omoplata,  Shoulder-blade. 

Position :  behind  on  the  Thorax,  behind  the  second  to  the 
seventh  ribs  on  either  side  of  the  vertebral  column,  very  move- 
able. 


THE  BONES.  81 

Shape :  triangular,  shield-like,  flat. 

Portions :  2  surfaces,  3  borders  and  angles. 

Connection :  with  the  Clavicle  and  Humerus. 

a.  Anterior  surface,  turned  towards  the  ribs,  concave ;  this  is  Fossa  sub- 
scapularis,  for  m.  subscapular^  lying  close  to  the  surface  of  the  back ;  Scapulx 
alatas  stand  off  from  it. 

tx  Posterior  surface,  divided  into  the  smaller  superior  fossa  supraspinata, 
for  m.  supraspinatus,  and  a  larger  inferior  fossa  infraspinata,  for  m.  infra- 
spinatus,  by  the  ridge,  Spina  scapulae,  for  trapezius,  deltoid :  this  is  triangular, 
presents  a  superior  and  inferior  surface,  an  external  short,  and  a  posterior 
thick  border,  close  beneath  the  skin,  with  a  triangular  surface,  for  the  m. 
Trapezius;  passes  forwards,  upwards  and  outwards,  to  the  top  of  the  shoulder, 
Acromion,  which,  triangular  and  flat,  projects  over  the  shoulder,  protects  the 
articulation  above  and  behind,  and  possesses  at  the  superior  border  a  small 
articular  surface  for  the  Clavicle. 

c.  Borders:    1.  Internal,  Vertebral  border,  Basis  scapulae,  the  longest,  with 
an  external  lip,  for  m.  rhomboideae,  and  an  internal,  for  m.  serratua  antic, 
major. 

2.  External  border,  the  thickest,  inclined  downwards  and  forwards  towards 
the  arm  £the  axillary  border],  for  m.  teretes  et  anconaeus  longus  [long  head  of 
the  Triceps],  above. 

3.  Superior  border,  sharp,  small,  for  m.  omohyoideus  with  Incisurae  scapulas  a. 
lunata,  formed  into  a  foramen  by  ligam.  tran&versum,  for  nerv.  suprascapularf 
it  passes  into  the  coracoid  process. 

d.  Angles :  1.  Internal,  almost  a  right  angle,  for  m.  lev.  anguli  scapulae. 

2.  Inferior,  very  pointed,  m.  Serratus  magnus,  attached  to  it,  separated  from 
the  skin  by  m.  latissimus  dorsi. 

3.  External,  is  the  oval,  vertical  Condylus  scap.  with  the  surface  Cavitas 
glenoidalis,  the  articular  fossa  for  the  head  of  the  humerus,  supported  by  a 
Collum  scapulas  under  which  the  Incisum  colli,  the  junction  of  the  fossae  supra 
et  infra  spinata,  over  which  the   Process,  coracoideus  projects,  for  the  short 
head  of  the  biceps,  at  the  apex  m.  coraco-brackialis,  pectoral,  minor,  farther 
above,  ligam.  coraco-clavicularia,  acromiale.     Proc.  coracoid.  bends  under  the 
clavicle,  forwards  and  outwards  over  the  shoulder  joint,  and  protects  it  from 
before. 

Development :  ossification  commences  in  the  centre,  at  the  end 
of  the  second  month  of  the  foetus.  In  advanced  childhood  the 
coracoid  and  acromion  are  still  cartilaginous;  they  contain,  like 
the  posterior  border  and  inferior  angle,  but  not  the  spina,  special 
osseous  nuclei.  The  acromion  has  two,  but  later.  The  P. 
coracoid  unites  with  the  body  of  the  bone  in  the  fifteenth  to  the 
sixteenth  year,  the  remaining  points,  especially  the  inferior  border, 
only  after  full  growth. 

95.  2.  Clavicula,  furcula,  Collar-bones,  2. 

Position :  before  and  above  the  first  rib,  between  shoulder- 
blade  and  breast-bone,  horizontal. 

Direction :  both  converge  forwards  and  rather  downwards,  to 
the  Sternum. 
6 


82  SPECIAL  ANATOMY. 

Figure :  cylindrical,  sigmoidal,  at  the  internal  extremity  thick 
and  round,  external  flat. 

Curvatures :  convex,  anteriorly,  in  the  sternal,  posteriorly,  in 
the  acromial  half. 

Connection:  with  the  breast  bone,  the  shoulder-blade,  and 
often,  with  the  first  rib. 

a.  Body,  middle  piece,  almost  immediately  under  the   skin,  is  frequently 
fractured,  with   Tubcrculum  for  m.    Cleido-mastuid.     Inferior  surface,  exter- 
nally broad,  with  a  rough  line,  for  m.  Subclavius ;  with  an  articular  surface 
internally,  for  the  first  rib ;  in  the  middle  third  corresponding  to  the  first  in- 
tercostal space,  for  Plex.  brachialis  et  Vasa  axilluria  •  the  outer  third,  united 
with  Proc.  coracoid,  by  the   ligam.   Conoid,  et   Trapezoid.     Posterior  border, 
two-thirds  concave,  one-third  convex,  externally.     Lies  on  Subclavian  vein  ; 
behind  that  Art.  et  Plexus  brachialis. 

b.  External  termination,  extrernitas  acromialis,  for  m.  trapezius  et  deltoideus, 
flat,  weak,  and  easily  broken ;  with  an  articular  surface  for  Acromion. 

c.  Internal  termination,  extremitas  sternalis,  enlarged,  angular,  covered  with 
cartilage,  projects  over  the  articular  surface  of  the  Manubrium  sterni  into  the 
incisura  clavicularis  of  which,  it  is  received  ;  for  m.  sterno-cleido-mastoid.,  and 
pedoralis  major. 

Varieties.  In  the  female  the  Clavicle  is  more  slender,  less  curved,  and 
more  horizontal.  Structure :  The  medullary  canal  in  the  interior  of  the 
Clavicle  is  very  small ;  the  extremities  consist  of  more  Spongy  tissue. 

Development,  at  a  very  early  period,  at  the  thirtieth  to  the 
thirty-fifth  day  from  one  osseous  nucleus  in  the  centre.  In  the 
fifteenth  to  the  eighteenth  year  an  osseous  nucleus  appears  as  a 
thin  disc  at  the  sternal  end.  In  mature  childhood  the  humerus 
is  only  about  |,  in  adults  £  larger  than  the  clavicle. 

The  shoulder  is  placed  before  and  behind  close  to  the  Thorax, 
but  stands  out  from  it,  and  the  space  thereby  formed  forms  the 
superior  part  of  the  cavity  of  the  axilla. 

96.  II.  Os  humeri  s.  brachii,  Bone  of  the  upper  arm. 

Position :  between  shoulder  and  fore-arm,  on  the  sides  of  the 
chest. 

Length :  reaching  downwards  to  the  second  Lumbar  vertebra, 
farther  in  Negroes. 

Direction:  parallel  with  the  axis  of  the  trunk,  yet  rather 
oblique  from  above  downwards,  and  without  inwards. 

Figure :  tubular,  cylindrical. 

Connection :  with  the  shoulder-blade  and  the  fore-arm. 

a.  Superior  extremity  with:  1.  Caput  humeri,  a  segment  of  a  sphere, 
about  £  5  lies  in  the  Cavit.  glenoid.  scapulae,  is  surrounded  by  a  circular  flat 
groove,  the  Collum  humeri  of  Anatomists,  and  forms  an  obtuse  angle  with 


THE  BONES.  83 

the  axis  of  the  shaft  of  the  bone.  2.  Tuberculum  majus,  on  the  outer  side, 
with  three  surfaces,  for  m.  supra-,  infraspinatus,  et  Teres  minor.  3.  Tuber- 
culum minus,  anterior,  for  m.  subscapularis.  4.  Sulcus  longitudinalis,  be- 
tween the  two  tubercles,  for  the  tendon  of  the  Caput  long,  bicipitis.  5.  Spina 
tuberc.  major \  for  m.  peel.  maj.  et  deltoid.  6.  Spina  tuberc.  mm.,  for  m.  teres 
maj.,  latiss.  dorsi,  et  coraco-brachial.  7.  Collum  humeri  chirurgorum  at  the 
superior  sixth  of  the  humerus  and  the  point  of  transition  into 

b.  The  middle  piece,  the  body.     Superior  half  cylindrical,  inferior,  triangu- 
lar, prismatic. 

1.  Surfaces:  external,  below  the  superior  third  a  V  shaped  depression,  for 
m.  Deltoideus.    Internal  anterior  surface,  for   m.   brachialis   internus,  oblique 
from  above,  downwards,  and  from  before,  inwards,  the  course  of  the  Art. 
brachiaKs,  presents :  Foram.  nutritium.     Posterior  surface  below  very  broad, 
for  m.  triceps. 

2.  Edges,  angles.     Anterior,  roundish,  rough,  the  commencement  of  spina 
tuber,  major.     External,  above  indistinct,  below,  sharp,  before  curved,  for  cap. 
intern,  tricip.  et  supinator  longus.     More  obliquely  below,  likewise,  sharp — 
from  Spina  tuberc.  minoris — for  cap.  intern,  tricip. 

c.  Inferior  extremity  flat,  broad;  presents,  from  without  inwards:  1.  Condy- 
lus  externus,  for  the  extensor  and  supinator  muscles.     2.  Eminentia  capitata  s.  ro- 
tula,  the  small  articular  head,  unites  with  the  Radius  of  the  fore-arm.     3. 
Trochlea,  it  receives  the  Ulna.     Above  it  we  find  Fossa  ant.  maj.  for  Proc. 
coronoideus  ulna,  minor,  for  the  radius ; — posterior,  for  Olecranon.     4.  Condylus 
internug,  for  the  flexor  muscles,  pronator  teres,  and  palmar,  long.,  behind  with  a 
flat  groove,  for  nerv.  ulnaris. 

Structure.  At  the  extremities  spongy  tissue,  in  the  body  compact  substance 
and  medullary  cavitiy. 

Development  commences  early,  second  month,  in  the  centre ; 
both  extremities  still  remain  cartilaginous  in  the  second  year;  then 
at  the  superior  extremity,  for  caput  and  tuberc*  majus  et  minus, 
three  osseous  nuclei  appear;  lastly,  at  the  inferior  extremity  four 
osseous  centres.  In  the  eighteenth  to  the  twentieth  year  the  ex- 
tremities first  unite  with  the  centre  piece,  the  inferior  soonest. 

97.       III.  Ossa  antibrachii.  Bones  of  the  fore-arm. 
1.   Ulna  s.  cubitus,  Elbow. 

Position:  on  the  inside  of  the  radius,  between  upper  arm  and 
hand,  on  the  same  side  as  the  little  finger. 

Shape :  prismatic,  triangular,  rather  twisted ;  above  thicker  than 
below ;  longer  than  the  radius. 

Direction :  rather  oblique  from  above,  downwards  and  out- 
wards. 

Connection:  with  the  upper  arm,  the  radius  and  cuneiform 
bone  by  the  ligam.  capsulare  sacciforme. 

a.  Superior  extremity,  behind,  has  the  hook-like  process,  Proc.  anconaug  s. 
Olecranon,  for  the  dnconeus  muscle,  the  extremity  of  which  moves  in  the  fossa 
olecrani  post.  •  anteriorly,  Proc.  coronoideus,  for  m.  BrachiaKs  internus,  the  point 


84  SPECIAL  ANATOMY. 

of  which  moves  in  the  Fovea  anterior ;  the  Basis  in  which  the  Olecranon  and 
Coronoid processes  meet  together,  is  thin  and  brittle;  between  the  two  :  Fossa 
sigmoidea  maj.',  for  the  Trochlea  of  the  upper  arm ;  minor  on  the  outer  border 
of  the  Coronoid  process  for  capitulum  radii  ;  under  that  a  rough,  deep,  triangular 
surface,  for  m.  supinator  brevis. 

b.  Centre  piece,  shaft,  1.  Surfaces ;  Anterior,  Vblar  •  above  broad,  with/oram. 
nutritium.     Muscles :  flex,  digit,  et  pollic.  long.,  carpi  ulnaris.     Posterior  surface : 
somewhat  convex,  divided  by  a  longitudinal  line.     Internal  surface :  abov  e 
very  broad ;  below  narrow,  and  close  beneath  the  skin,  smooth. 

2.  Borders.  External,  crista,  the  sharpest,  particularly  in  the  centre,  dimin- 
ishes below  for  abduct,  long,  et  extern,  brevis.  pollic.,  ligam.  interrosseum.  Anterior 
or  internal,  obtuse,  for  flex,  digitor.  comm.,  pronator  quad.  Posterior :  commences 
below  the  Olecranon,  and  is  lost  on  the  inferior  fourth ;  perceptible  through 
the  skin. 

c.  Inferior  extremity,  for  M.  pronator  quadratus.  Capitulum  s.  condylus  ulna 
unites  with  the  inferior  extremity  of  the  Radius  and  the  cuneiform  bone.     In- 
ternal to  the  small  head,  Proc.  styloideus,  for  ligam.  laterale  intern,  of  the  hand 
and  fore-arm  -;  between  the  two  a  hollow,  for  ligam.  triangulare. 

Structure.  Compact  in  the  centre,  spongy  at  both  extremities,  particularly 
at  the  elbow.  Olecranon  sometimes  forms  a  special  bone. 

Development:  three  osseous  nuclei.  The  first  appears  in  the 
body  at  the  thirty-fifth  to  the  fortieth  day  of  the  foetus.  The  ex- 
tremities only  ossify  with  the  sixth  year,  and  the  inferior  first. 
In  the  fifteenth  to  the  sixteenth  year  the  middle  unites  with  the 
superior,  in  the  eighteenth  to  the  twentieth  year  with  the  inferior 
extremity. 

98.  2.  Radius. 

Position :  on  the  outer  side  of  the  Ulna,  on  the  same  border  as 
the  thumb, — radial  border. 

Shape:  prismatic  and  triangular,  above  thin,  below  thick;  in 
the  centre  slightly  curved. 

Connection:  with  the  upper  arm,  rotula  proc.  cubital.,  Ulna, 
the  wrist,  os  lunare,  naviculare. 

a.  Superior  extremity.     1.  Capitulum  radii,  with  a  lateral,  annular,  articular 
surface,  circumferent.  articular.,  for  the  fossa  sigmoid.  minor,  and  a  superior,  for 
the  rotula. 

2.  Collum,  five  to  six  lines  long,  inferior  limit  of  which : 

3.  Tuberositas  radii,  for  m.  biceps,  the  tendon-  behind,  rough ;  before,  smooth. 

b.  Central  piece,  shaft,  slightly  curved,  internally  concave.     1.  Borders:  an- 
terior, blunt,  commences  from  the  tuberosity,  passes  obliquely  outwards,  and 
terminates  below,  before    the  Proc.  styloideus  ;   posterior,  above  and  below 
slightly  marked ;  external,  for  ligam.  interosseivm,  Crista,  from  the  tuberosity  to 
a  small  articular  surface  below  and  internal. 

2.  Surfaces:  Anterior;  above, narrow ;  below,  broad;  withybrcww.  Nutritium, 
for  m.  supinator  brevis,  flex,  pollicis  long.,  digitor.  commun.  sublimis.  External 
surface,  convex,  lor  m.  Pronator  teres.  Posterior  surface,  rather  hollow,  for 
m.  abduct,  pollicis  longus. 

b.  Inferior  extremity,  thick,  quadrangular,  for  m.  pronator  quadratus,  with 


THE  BONES.  85 

an  inferior,  concave,  divided,  articular  surface,  1.  Cavitas  glenoidalis,  for  os  navi- 
culare,  on  the  outside,  os  limatum  on  the  inside.  2.  Externally :  proc.  styloideus, 
for  supinat.  longus,  between  the  anterior  and  external  border,  a  groove,  for  m. 
abduct,  long,  and  extens.  brevis  poUicis.  On  the  circumference  upon  the  dorsal 
aspect  3.  Two  grooves,  for  the  tendons  of  the  extens.  carpi  radial,  long,  and 
brevior;  anteriorly,  for  those  of  the  extens.  digit,  comm.,  and  behind,  pollic.  long. 
Jncisura  semilunaris,  in  which  the  Capitulum  Ulnae,  moves. 

Development  proceeds  from  three  osseous  points,  first  in  the 
central  piece  ;  in  the  inferior  extremity,  towards  the  third  year, 
in  the  superior  towards  the  ninth ;  the  last  unites  with  the  shaft 
in  the  twelfth  year ;  the  first  in  the  eighteenth  to  the  twentieth. 

99.  IV.    Ossa  manus,  Bones  of  the  hand. 

1.  Carpus,  root  of  the  hand,  wrist,  about  an  inch  long,  2 2 
broad,  consists  of  eight  short  bones,  lying  close  together  in  two 
rows,  one  above  the  other,  and  four  bones  in  each.  The  wrist  is 
united  above,  with  the  fore-arm ;  below,  with  the  metacarpal 
bones  ;  concave  upon  its  anterior  or  palmar  surface,  hollow  of 
the  hand,  it  forms  with  the  ligam.  carp,  volare  prop.,  a  ring  for 
the  tendons  of  the  flexor  muscles  ;  convex  on  the  posterior,  dor- 
sal surface.  It  presents  an  Ulnar  and  Radial  border, —  Vola,  pal- 
mar— Dor  sum  manus,  dorsal  surface,  back  of  the  hand. 

EminentisR  carpi  are  two  projections  on  either  border  of  the 
palmar  surface. 

At  the  ulnar  border:  1.  the  superior,  05  pisiforme ;  2.  the 
inferior,  the  hooked  process  of  the  unciform  bone. 

At  the  radial:  1.  the  superior,  os  naviculare ;  2.  the  inferior, 
os  trapezium. 

a.  Bones  of  the  superior  row  passing  from  the  Radial  to  the 
Ulnar  border. 

1.  Os  naviculare  s.  Scapkoideum  lies  below  the  radius,  above  three  bones  of 
the  second   row,  with  a  deep,  articular  fossa,  for  os  Maguum.  with  a  convex,   . 
articular  surface,  for  oss.  trapezium  et  trapezoid.,  the  largest  bone  of  the  first 
row. 

2.  Os  lunatum,  semilunare,  lunar  bone,  lies  below  the  radius  above  the  os 
magnum,  between  1.  and  3. 

3.  On  [cune/forme]  triquttrum,  pyramidal  bone,  below  the  Ulna,  above  the 
unciform  bone. 

These  three  bones,  when  united,  are  convex  above,  concave  below.  They 
are  connected  with  the  fore-arm. 

4.  Os  pisiforme,  pea-like  bone,  for  flex,  carpi  ulnar!*,  abduct,  digiti  5,  lies 
free  in  the  hollow  of  the  hand,  only  united  with  the  pyramidal  bone  [cunei- 
form] at  the  ulnar  border. 

b.  Bones  of  the  inferior  row  from  the  radial  to  the  ulnar  border. 


86  SPECIAL  ANATOMY. 

1.  Os  [Trapezium]  multangulum  majus,  for  opponens,  abductor  brevis  pol- 
licis,  below  the  navicular,  above  the  first  metacarpal  bone ;  with  a  groove  in 
its  palmar  surface,  for  the  tendon  of  the  flexor,  carp.  rod. 

2.  Os  [Trapezoides],  multangulum    minus,  s.  pyramidale,  for  flex,  pollicis 
brevis,  below  the  navicular,  above  the  second  Os  Metacarpi.     Ossa  multangula 
form  a  concave,  articular  surface,  for  os  naviculare. 

3.  Os  [magnum"],  capitatum,  for  adductor,  and  flex,  brevis  pollicis,  below  the 
scaphoid  and  semilunar  bones,  above  the  third  metacarpal  bones ;  with  Capi- 
tulum. — The  largest  bone  of  the  second  row. 

4.  Os  [unciforme'],  hamatum,  hooked  bone,  below  the  cuneiform,  above  the 
oss.  metacarp.  iv.  and  v.     Its  hook,  proc.  uncinatus,  for  m.  flex,  brevis  et  op- 
ponens digiti  5,  lies  close  to  the  pisiform  bone. 

Os  capitatum  et  hamatum  form  an  articular  head,  for  the  articular  fossa  of 
the  first  row. — The  Middle  bones  have  four,  the  external  only  three  articular 
surfaces. 

Structure,  The  carpal  bones  consist  of  a  spongy,  bony  mass,  covered  ex- 
ternally with  compact  tissue.  Ossification  commences  after  birth ;  at  the  end 
of  the  first  year  in  the  magnum  and  the  unciform  bone ;  between  the  third  and 
fourth  years  in  the  cuneiform ;  between  the  fourth  and  fifth  in  the  trapezium 
and  semilunar;  between  the  eighth  and  ninth  in  os  naviculare  and  trapezoid; 
between  the  twelfth  and  fifteenth  in  os  pisiforme,  which  is  generally  the  latest 
perfected  of  all  the  bones. 

100.  2.  Metacarpus,  Middle  hand, 

consists  of  five  parallel,  columnar  bones,  which,  united  together 
like  a  grating,  are  connected  with  the  carpal  bones  and  phalanges 
of  the  fingers. 

a.  Superior  carpal  end,  Basis;  enlarged,  rather  hollowed  out,  for  the  recep- 
tion of  the  carpal  bones;  tri-  or  quadrangular,  with  two  small  lateral  surfaces 
to  receive  the  lateral  metacarpal  bones. 

Basis,  oss.  Metacarp. 

I.  For  abduct,  poll,  long.,  unites  with  os  trapezium. 

II.  Yorflex.  et  extens.  carp.  rad.  longior.,  with  os  [Trapezium],  Trapezoid,  and 
[Magnuni], 

III.  For  extens.  carp.  rad.  brev.,  with  os  magnum. 

IV.  With  os  [magnum']  and  unciforme. 

V.  For  extens.  carpi  ulnaris.,  with  os  unciforme. 

b.  Central  part,  for  in.  interossei,  roundish,  triangular,  rather  concave  on  the 
palmar  aspect. 

c.  Inferior,  digital  end,  capitulum,  with  two  tubercula  and  one  sinus  on  either 
side. 

Capitul.  oss.  metacarpi :     I.  for  m.  opponens,  abduct,  brev.  pottic. 

V.  for  m.  opp.  minimi  digit. 

I.,  The  metacarpal  bone  of  the  thumb,  is  shorter  and  thicker  than  the  rest; 
has  no  lateral  articular  surfaces,  and  is  moveable  in  a  free  joint,  Jlrthrodia. 

II.  is  the  longest,  has  on  its  base  only  one  lateral  articular  surface.  A  little 
shorter,  but  thicker,  is 

III.,  with  two  lateral  articular  surfaces. 

IV.  is  shorter,  and  V.  shorter  still.  The  last  has  only  one  articular  surface, 
but  a  tubercle  on  the  base,  for  m.  extens.  carp,  ulnaris. 


THE  BONES.  87 

Structure,  as  in  the  long  bones,  spongy  substance  at  the  ends,  compact  in 
the  centre,  medullary  canal,  but  narrow,  in  the  interior. 

Development ;  from  two  osseous  points,  one  for  the  centre  and 
superior,  one  for  the  inferior  extremity.  The  I.  metacarpal  at 
the  superior  end  like  the  phalanges,  which  it  also  resembles.  At 
birth  the  central  piece  is  almost  entirely  ossified ;  at  the  extre- 
mities ossification  commences  between  the  second  and  third  year, 
and  is  only  completed  with  the  eighteenth  to  the  twentieth  year. 

10L  3.  Digiti,  fingers. 

On  either  hand  there  are  five  articulated  pyramids,  each  of 
which  unites  with  one  of  the  five  metacarpal  bones. 

I.  Finger,  thumb,  has  two,  the  rest  three  members,  phalanges. 
The  first  of  the  three,  or  two  members,  is  united  with  the  end  of 
the  metacarpal  bone,  the  third  (second)  is  free,  as  the  ungual. 
Each  phalanx  has  a  superior,  hollowed  extremity,  for  the  recep- 
tion of  the  bone  lying  above  it,  an  anterior  concave  body,  and  an 
inferior  roller-like  end,  for  its  junction  with  the  phalanx  below  ; 
only  the  ungual  member,  phalanx  unguicularis,  terminates  in  a 
semilunar  end. 

I.  Thumb,  pottex  ;  in  it  the  centre  Phalanx  is  wanting ;  on  the  base  of  the 
first,  at  the  metacarpal  end  in  the  hollow  of  the  hand,  lies  an  os  sesamoideum 
externum,  for  m.  flexor  pollicis  brevis,  and  internum,  for  m.  abductor  pollicis. 

1.  Phalanx — sup.  Extremity,  for  extern,  et  abd.  brevis. 

2.  „  „  for  flex,  et  extens.  long. 

II.  Index  finger. 

1.  Phalanx,  Radial  side,  for  m.  lumbriccUis  /.,  Interosseus. 

2.  „        for  m.flex.  comm.  subl.,  extens.  comm. 

3.  „        for  m.  flex.  comm.  prof.,  extens.  prop. 

III.  Middle  finger,  digitus  med.,  muscles  as  in  II. ;  the  last  excepted. 

IV.  Ring  finger,  dig.  anmdaris.  as  in  III. 
V.  Ear  finger,  dig.  auricularis  s.  minimus. 

1.  Phalanx,  for  abduct,  et  flex,  brevis. 

2.  „         for  flex.  comm.  subl.,  opponens. 

3.  „         for  flex.  comm.  profundus. 

Development.  Each  of  the  phalanges  is  ossified  from  two 
points,  the  body  and  the  inferior  extremity,  in  the  third  foetal 
month.  The  extremity  first  unites  with  the  body  between  the 
eighteenth  and  twentieth  year  after  birth. 

Abdominal  Extremities. 
B.  Extremitates  inferiores  s.  abdominales. 
102.  I.  Osfemoris,  Thigh-bone. 

Position:  close  to  and  beneath  the  Pelvis,  above  the  leg. 
Shape:  long,  cylindrical,  with  thick  extremities:  the  longest 
bone  in  the  body. 


88  SPECIAL  ANATOMY. 

Direction:  from  above  to  below,  and  from  without  to  within, 
particularly  in  the  female. 

Connection  :  with  the  acetabulum  of  the  pelvis  and  the  shin- 
bone. 

a.  Superior   extremity — taking   a  course  from  the  shaft  or  centre   piece 
from  without,  inwards  and  upwards.     On  it, 

1.  Caput  femoris,  head  of  the  thigh  bone,  almost  two-thirds  of  a  sphere  with 
fovea,  for  ligam.  teres. 

2.  CoUum,  neck  of  the  thigh  bone ;  forms  with  the  central  piece  an  obtuse 
angle ;  fiat.     Anterior   surface  short,  posterior    longer   and   rather   concave. 
Behind  it      • 

3.  Trochanter  Major,  above  and  externally  in  a  plane  with  the  corpus  femo- 
ris, for  m.  glutaus  med.  and  minimus,  pyriformis,  quadratus  femoris,  with :  Fossa 
trochanterica,  for  m.  gemelli  et  obturatores. 

4.  Trochanter  Minor,  below  and  internally  from  the  base  of  the  neck,  for 
the  tendon  of  the  m.  Psoas  et  iliacus. 

5.  Linea  intertrochanterica  anterior,  for  m.  cruralis,  posterior,  [part]  for  m. 
quadratus  femoris. 

b.  Centre  piece,  body.     Anterior   surface  rather  convex,  inferior  broader 
than  above,  for  m.  cruralis.     Internal  surface,  flat,  below  broader  and  directed 
backwards,  indicating  course  of  art.  femoralis.     External  surface,  narrow,  in 
the  longitudinal  direction  rather  concave ;  the  external  and  internal  borders 
are  roundish.     Posterior  border,  sharp  and  rough,  the  Linea  aspera;  above  and 
hslow  divided.     Above,  the  external  angle  terminates  in  the  Trochant.  major, 
the  internal,  the  more  feeble,  in  Troch.  minor. 

Internal  angle,  for  m.  pectineus  adductor  brews,  vastus  intern. 

External  angle,  for  m.  Glutaus  max.,  adductor  magnus,  vastus  externus,  Caput 
breve  bidpitis. 

Centre,  the  linea  aspera,  for  m.  adductor  longus  et  magnus,  with :  Foramen 
nutritium.  Below,  the  Linea  aspera  terminates  in  the  two  condyles,  for  the 
m.  gastrocnemii,  between  which  is  a  triangular  space,  the  superior  part  of  the 
fossa  poplitcea,  for  art.  ven.,  et  nerv.  poplitceus. 

c.  Inferior  extremity  broad,  flat  from  before  to  behind ;  with 

1.  Condylus  externus,  for  m.  Poplitceus,  plantaris,  Cap.  extern,  m.  gastroc.  upon 
a  plane  with  the  corp.  femoris. 

2.  Condylus  intern,  projects  very  much  inwards  from  the  axis,  for  Cap. 
intern,  m.  gastroc. 

On  the  articular  head : 

1.  Inferior  articular  surface,  for  the  tibia  and  patella. 

2.  Tuberositas  interna  projects  greatly;  over  it  a  surface,  for  m.  adduct.  mag- 
nus ;  externa,  less  marked,  with  a  tubercle.     Both  for  ligamenta  crudata. 

Between  them : 

3.  Posterior  Fossa  intercondyloidea,  forms  the  fossa  of  the  knee. 

4.  Anterior  Trochlea  femoris,  corresponds  to  the  Patella. 
Structure :  type  of  the  long  bones. 

Development:  five  osseous  centres:  one,  for  the  body,  one  for 
each  extremity,  one  for  each  Trochanter.  The  first  appears  in 
the  body,  between  the  fortieth  and  fiftieth  days;  the  second  in  the 
inferior  extremity,  regularly,  in  short,  before  the  maturity  of  the 
foetus ;  the  third  in  the  middle  of  the  head  at  the  end  of  the  first 


THE  BONES.  89 

year.  The  neck  ossifies  by  extension  from  the  body.  The  Tro- 
chanter  major  ossifies  in  the  fourth  year, — minor  in  the  thirteenth 
or  fourteenth.  Both  are  first  united  to  the  head  towards  the 
twenty-eighth  year,  the  other  parts  soon  after  puberty. 

103.  II.   Ossa  cruris,  Bones  of  the  leg. 

1 .   Tibia,  shin-bone. 

Position :  below  the  thigh-bone,  above  the  foot,  on  the  inside 
of  the  Fibula,  on  the  same  border  asv  great  toe,  Tibial. 

Direction :  vertical. 

Shape:  three-sided,  prismatic;  above  and  below  enlarged. 
The  strongest  and  longest  bone  next  to  the  femur. 

Connection:  with  osfemoris,  Fibula  (immoveable) ;  Astraga- 
lus ;  the  Patella  by  ligam.  Patellae. 

a.  Superior  extremity,  caput  tibice,  broad,  much  stronger  than  the  inferior 
extremity. 

1.  Cavitas  glenoidalis  internet,  longer  and  deeper  than  externa.     Both  oval, 
concave,  for  Condyli  femoris :  divided  by 

2.  Eminentia  intermedia,  pyramidal,  rather  posterior,  for  ligam.  cruciata  ;  sup- 
ported by 

3.  Condylus  interims,  behind  with  a  horizontal  groove,  for  the   Tendon  of 
Scmimembranosiis,  and  by  Condylus  extern.,  a  slight  enlargement  with  the  small 
external  superficies  peroncea,  for  the  head  of  the  fibula.     Posteriorly  between 
the  condyles — a  deeper  notch,  incifura  poplitea;  before  a  triangular  surface 
with  several  foramina,  and  under  that, 

4.  Spina  tibia,  rough,  for  tendo  communis  recti,  crural,  vasti,  externally  and 
above  a  tubercle,  for  m.  tibiaL  anticus. 

b.  Central  piece;  three-sided,  thick,  M'eakest  in  the  inferior  third. 
Internal  surface,  above,  covered  by  an  Aponeurosis,  pes  anserinm,  below 

only  by  the  external  skin,  above  broad  and  oblique  from  before  inwards,  infe- 
rior fourth  narrow  and  directed  directly  in  wards. 

External  surface,  for  m.  tibiaL  ant.  et  extens.  digit,  comm.,  above  concave, 
below  directed  forwards. 

Posterior  surface,  for  m.  tibialis  posticus  and  flex,  digit,  comm.,  above  broad ; 
with  Linea  obliqua,  for  m.  Soleus,  and  a  triangular  surface,  for  m.  popliteus  • 
Foramen  nutritium. 

Anterior  border,  Crista  tibia,  close  under  the  skin,  sharp,  rounded  in  the 
inferior  fourth :  continuation  of  Spina. 

External  border,  for  ligam.  inteross.,  divided  below. 

Internal  border,  obtuse,  for  rn.  sartor.,  gracilis  et  semitendinosMS. 

c.  Inferior  extremity,  basis,  almost  four-sided,  broad ;  before  convex,  for  the 
Extensor  tendons;  behind,  even  with  a  slight  fossa,  for  tendo  m.  flex,  halhtcis 
long.  •  externally,  a  triangular  fossa,  Incisiira  fibularis,  for  the   Fibula ;  inter- 
nally, the  thick  four-sided  MaUeolus  internus.  springing  strongly  forwards.    The 
posterior  border  of  the  internal  malleolus  presents  an  oblique  fossa  descending 
from  without  inwards,  for  the  tendons  of  tibial.  post.  e\  flex,  digit,  long.     The 
external  surface  assists  in  forming  the  inferior  articular   surface.     This  last, 
fossa  glenoidalis,  is  four-sided,  broader  externally,  divided  by  an  elevation  into 

two  lateral  halves,  and  it  unites  with  the  jlstragalus. 


90  SPECIAL  ANATOMY. 

Structure.  The  spongy  mass  of  the  Extremities  is  perforated  by  numerous 
vascular  foramina. 

Development.  Three  osseous  points.  In  the  body  the  first 
appears  between  the  thirty-fifth  and  fortieth  days ;  in  the  superior 
extremity  with  the  conclusion  of  the  first  year ;  in  the  inferior 
extremity  in  the  course  of  the  second.  The  union  of  the  three 
portions  commences  at  the  inferior  extremity,  and  is  only  perfect 
when  the  growth  is  complete,  between  the  eighteenth  and  the 
twenty-fifth  year. 

104.  2.  Fibula  s.  Perone. 

Position:  upon  the  outer,  as  well  as  above,  upon  the  posterior 
side  of  the  shin  bone,  on  the  same  side  as  the  little  toe  of  the  foot, 
— Fibula  border. 

Direction  :  vertical,  below  a  little  external. 

Figure:  thin,  long,  like  the  tibia,  twisted. 

Connection :  with  the  tibia,  the  astragalus  ;  and  with  the  os 
femoris  by  the  ligam.  lateralia. 

a.  Superior  extremity,  capitulum  •  with :  superficies  tibialis  superior,  the  con- 
cave articular  surface  of  the  Tibia ;  externally,  flat  fossae  for  ligam.  lateralia 
extern,  et  m.  biceps  •  behind;  and  above  the  point,  apex  seu  proc.  styloideus,  for 
M.  biceps. 

b.  Central  piece,  three-sided,  prismatic.     External  surface,  grooved,  for  m. 
perorueus  long,  et  brevis,  inferiorly  one-fifth  directed  backwards. 

Internal  surface,  divided  by  a  Crista,  for  lig.  interosseum  into  two  halves,  for 
Tibial  postic.,  peron&us  tertius,  and  extens.  hallucis  longus  ;  below  turned  for- 
wards. 

Posterior  surface,  above  narrow,  below  broad  and  directed  inwards,  with 
Foram.  nutritium,  Muscles:  soleus,  flex,  hallucis  longus.  The  borders  are 
sharp ;  the  internal,  for  ligam.  interosseum  inclines  forwards,  the  anterior  out- 
wards, the  external  backwards. 

c.  Inferior  extremity,  projects  beyond  the  articular  surface  of  the  Tibia,  is 
longer  and  thicker  than  the  inferior  extremity  of  the  last.     Malleolus  externus  : 
external  surface  convex,  lies  close  beneath  the  skin ;  internal  surface  forms 
the  articular  fossa  for  the  astragalus  and  unites  with  the  Tibia;  with  Twber- 
cidum   anticum    et   posticum,  for    the    ligam.  tibiofibularia ;  posterior  surface, 
grooved  for  the  tendons  of  the  two  peron&i,  with  fossa  malleoli  externa,  for  ligam. 
jibulare  tali  post. 

Structure.  The  medullary  canal  in  the  centre  is  very  narrow ;  the  extre- 
mities are  spongy. 

Development.  Three  osseous  nuclei ;  the  first,  in  the  centre 
piece,  appears  between  the  fortieth  and  fiftieth  days,  foetal;  the 
second,  in  the  inferior  extremity  only,  in  the  second  year ;  the 
third,  at  the  superior  extremity,  in  the  fifth  year.  The  inferior 
extremity  first  unites  with  the  body,  between  the  twentieth  and 
the  twenty-fifth  year. 


THE  BONES.  91 

105.  3.  Patella  s.  Rotula,  Knee-pan. 

Position :  between  femur  and  tibia,  before  the  knee.  The 
largest  os  sesamoideum. 

Figure :  flat,  roundish,  triangular,  however  very  variable ;  above 
broad,  below  pointed. 

Connection:  with  the  femur  and  tibia. 

a.  Anterior  surface,  convex,  covered  by  a  thick  fibrous  tissue,  beneath  the 
skin. 

b.  Posterior  surface,  fits  close  upon  the  Trochlea  of  the  inferior  extremity  01 
the  femur;  is  covered  with  cartilage,  and  presents : 

1.  Crista,  from  above,  downwards  and  inwards. 

2»  Fossa  articular,  externa,  broad,  and  interna,  narrow. 

c.  Circumference.     Superior   border,  basis,  thick,  for   the    tendons   of  the 
extensors   of  the    leg.     Lateral   borders,  for  lig.  capsulare.     Point,  apex,  lies 
towards  the  Spina  tibia  [for  ligam.  Patettte]. 

In  flexion  of  the  leg  upon  the  thigh  the  Patella  remains  fixed  and  pfo- 
jects,  in  extension  it  is  moveable  and  serves  as  a  roller  for  the  Extensor 
muscles. 

Structure.  Entirely  spongy,  only  covered  upon  the  anterior  surface  with  a 
thin  layer  of  compact  tissue  which,  as  an  exception  in  these  short  bones,  con- 
sists of  longitudinal  fibres. 

Development.     From  one  osseous  centre  in  the  third  year. 

III.  Ossa  pedis,  Bones  of  the  feet. 

106.  1 .   Tarsus,  root  of  the  foot,  instep, 

consists  of  seven  bones,  placed  unequally  in  two  rows;  arched 
above,  hollow  below. 

a.  Posterior  row,  consists  of  the  two  largest  bones  of  the 
Tarsus. 

1.  Astragalus  s.  Talus,  knuckle  bone.     Situation  and  connection:  below  the 
Tibia,  above  the  Colds,  internal  to  Malleolus  externus,  fibulae,  behind  the  navicular 
bone.     Figure  irregularly  cubical.     Six  surfaces.     Body  and  head. 

a.  Body.     Superior  surface,  a  half  trochha  for  the  tibia;  Lateral  surfaces 
flat  enclosed  by  the  malleoli.     Inferior  surface,  for  calcaneus,  concave.     Poste- 
rior surface  with  a  groove,  for  flex,  halluc.  long. 

b.  Head,  for  os  naviculare,  united  to  the  body  by  the  Collum  astrag.,  has 
above,  a  broad  notch,  before,  an  articular  surface,  for  os  naviculare,  below,  a  fossa 
which  forms  with  another  on  the  Proc.  anterior  Calcanei,  the  Sinus  tarsi;  lies 
on  the  anterior  surface  of  the  astragalus. 

2.  Calcaneus,  heel  bone,  the  largest  of  the  tarsal  bones.     Position :  below 
the   Astragalus,  behind   the  Cuboid.     Figure:  longitudinal  5  a  body  and  pro- 
cesses. 

a.  Body.  Posterior  termination,  proc.  poster,  s.  calx,  heel,  for  the  tendo* 
Jlchillis;  inferior,  narrow  surface,  with  two  tubercles;  superior  surface,  with 
two  convex  articular  surfaces,  for  the  Astragalus ;  external  surface,  only  covered 


92  SPECIAL  ANATOMY. 

by  skin,  with  two  grooves,  for  the  tendons  of  peron&i,  and  a  tubercle  before 
and  above,  important  in  a  Surgical  point  of  view,  as  a  guide  in  exarticulatio 
ped.  Chopart.  Internal  surface,  deeply  concave,  forms  with 

b.  Process,  intern,  s.  minor,  a  blunt  hook,  projecting  forwards  and  upwards, 
and  having  an  articular  surface,  for  proc.  anter.  astrag.,  the  Sinus  tarsi,  for  the 
tendons,  vessels,  and  nerves  of  the  sole  of  the  foot.     Below  it  a  sulcus,  for  the 
tendon  flex,  halluc.  long. 

c.  Process,  ant.  s.  magnus,  represents  the  anterior  surface  of  the  Corp.  Cal- 
canei;  has  anterioly  an  articular  surface,  for  os  cuboid;  is  externally  rough,  for 
abduct,  digit.  5,  and  extens.  brevis;  internally  a  small  process  projects,  sustenta- 
culum  tali. 

b.  Anterior  row,  consists  of  five  bones,  namely : — 

3.  Os  naviculare  s.  scaphoideum.     Position:  on  the  same  side  as  the  great 
toe,  before  the  talus,  behind  the  three  cuneiform  bones,  internal  to  the  Cuboid. 
Figure:    longitudinal,  flat.     Posterior    surface,  concave,  for    Talus;  anterior, 
convex  for  the  three  cuneiform  bones;  superior,  convex,  free  upon  the  back  of 
the  foot;  at  the  internal  extremity,  tubei".  oss.  navicularis,  for  attachment  of  m. 
Tibialis  posticus,  perceptible  through  the  skin;  at  the  external  termination  a 
small  articular  surface,  for  the  os  cuboideum. 

4,  5,  6.   Ossa  civneiformia,  three  small,  four-sided  bones.     Position:  between 
Navicular  and  the  three  internal  metatarsal  bones. 

I.  Os  cuneiforme,  at  the  side  of  the  foot,  the  largest;  internal  surface,  beneath 
the  skin;  external,  angular,  for  the  second  cuneiform  and  two  metatarsal  bones; 
posterior  concave,  for  the  navicular;  anterior  rather  convex,  for  the  first  meta- 
tarsal; inferior,  with  tuberculum,  for  m.  tibialis  anticus. 

II.  Os  cuneiforme  lies  between  I.  and  II. ;  is  the  smallest,  for  the  second  os 
metatarsi. 

III.  Os  cuneiforme,  between  II.  and  the  cuboid  bone,  for  the  third  os  metatarsi, 
m.  adductor,  halluc. 

7.  Os  cuboideum,  Cube  bone.  Position:  before  the  calcis,  behind  the  fourth 
and  fifth  metatarsal  bones,  outside  the  navicular  and  os  cuneiforme  III.;  on  the 
outer,  little  toe,  border.  Superior  surface,  with  sulcus  oss.  cub.,  for  the  tendon 
of  m.  peronceus  long,  on  the  outer  border.  Inferior  surface,  with  the  eminentia 
obliqua,  for  ligam.  calcan.-cuboid. 

Development,  Calcis  and  Astragalus  ossify  even  in  the  sixth 
month  of  foetal  existence ;  the  rest  only  in  the  first  year  after  birth ; 
but  Tuber  calcanei  only  in  the  tenth  year. 

107.  2.  Metatarsus,  middle  foot, 

consists  of  five  columnar,  parallel  bones  united  like  a  grating  with 
four  interstitia  interossea.  Position :  horizontal  between  tarsus 
and  toes.  Connection :  behind  with  the  three  cuneiform  and  the 
cuboid  bones;  before  with  the  first  phalanges  of  the  toes;  with 
one  another.  Structure :  the  same  as  the  long  bones. 

a.  Posterior  extremity.  .Basis,  from  the  first  to  third  metatarsal  bone,  cor- 
responds with  the  three  cuneiform  bones ;  that  of  the  fourth  and  fifth  with  the 
cuboid ;  with  one  posterior,  for  the  tarsus,  and  two  or  one  lateral  articular  sur- 
faces for  the  metatarsus. 


THE  BONES.  93 

I.  Os  metatarsi,  for  m.  tibial.  antic.,  flex,  brevis,  abduct,  halktcis,  on  the  great 
toe  border;  very  strong;  the  posterior,  articular  surface,  for  the  first  cuneiform 
bone,  longitudinally  concave,  both  lateral   surfaces  wanting;  on  the  Plantar 
border,  tuberculum  plantare,  for  tendon  of  Peronceus  long. 

II.  Os  metatarsi,  with  three  articular  surfaces  for  the  three  cuneiform  bones 
[two  lateral,  one  posterior],  and  one  for  the  third  os  metatarsi. 

III.  Os  metatarsi;  three  articular  surfaces,  namely,  one  behind  for  third 
cuneiform,  two  lateral  for  second  and  third  os  metatarsi.     III.  and  IV.  for  m. 
adductor  hattucis. 

V.  Os  metatarsi,  for  peronaus  3,  flex,  brevis  digiti  5,  with  only  one  lateral 
articular  surface  for  the  IV.  os  metatarsi ;  and  tuberositas  on  the  free  outer 
border,  for  m.  peronaus  brevis  s.  Proc.  triangularis  and  abductor  digiti  5,  pro- 
jects backwards  and  outwards,  important  in  exarticulatio  metatarsi. 

b.  Middle  portion,  diaphysis,  for  m.  interossei;  three-sided.     Superior  surface 
rather  convex ;  internal  and  external  meet  below  in  the  concave,  plantar  sur- 
face, at  an  acute  angle.     L  II.,  os  metatars.,  are  the  longest  and  strongest    V., 
flat  and  thick. 

c.  Anterior  extremity,  capitidum,  with  anterior,  convex,  articular  surface, 
which  is   largest  in  the  sole ;  and  two  lateral  fossa?,  sinus,  and  two  tuber- 
cula,  for  ligam.  lateralia. 

The  first  os  metatars.  projects  into  the  sole  of  the  foot,  ball ;  and  has  two 
grooves,  for  ossa  sesamoidea.  IV.  and  V.,  for  caput  breve  m.  transversal,  pedis. 

Development  of  the  metatarsus  begins  in  the  third  foetal  month 
with  one  osseous  nucleus  in  the  centre  piece,  and  with  another  at 
the  anterior  (in  the  first  os.  metatars.  at  the  posterior)  extremity 
in  the  second  year,  but  only  in  the  eighteenth  year  are  the  pieces 
completely  united  together. 

108.  Digiti  Pedis,  Toes, 

five  on  each  foot,  each  consisting  of  three,  the  great  toe  of  two 
members,  phalanges. 

Phalanx  I.  the  largest  Ph.  II.  small  and  short.  Ph.  III.  Ungual,  the 
smallest,  flat  The  posterior  extremity,  basis,  of  each  phalanx  is  even,  con- 
cave, for  capitul.  metatarsi,  with  tubercula  on  either  side.  The  anterior  ex- 
tremity roller  shaped,  convex,  with  a  sinus  on  either  side  ;  that  of  the  third 
Ph.  free,  semilunar. 

1 .  Hallux,  great  toe ;  two  members ;  thick  and  large,  less  moveable  than 
the  fingers,  on  account  of  its  strong  ligament     To  the  plantar  surface,  flexor 
brevis,  to  the  basis  the  first  Phalanx. 

2.  Ossa  sesamoidea,  for   abducior  and  adductor  hallucis;  Dorsal  surface  of 
first  Phalanx,  for  m.  extensor  hall,  brevis.     To  the  basis  the  second  Phalanx — 
one  os  sesamoideum: — Plantar  surface,  for  flex.  hall.  long.     Dorsal  surface,  for 
extens.  hall,  l&ngus. 

Second  to  fifth  toes  are  always  smaller. — First  Ph.,  for  m.  lumbricales.  Se- 
cond Ph.,  for  flex.  comm.  brevis.  Third  Ph.,  basis,  for  flex.  comm.  long.  Dor- 
sal surface  of  all  three,  for  extens.  comm.  long,  and  brevis. 

Fifth  small  toe,  Digitus  minimus.  First  Ph.,  basis,  for  flex.  brev.  and  abduct, 
digiti  5. 


94 


SPECIAL  ANATOMY. 


Development.  Two  osseous  nuclei,  a.  in  the  centre  piece,  at 
the  end  of  the  third  foetal  month;  b.  in  the  posterior  end,  ext. 
halluc.  The  second  phalanx  ossifies  last.  At  birth  the  apex  of 
the  ungual  phalanx  is  ossified. 


109. 


Characteristics 


of  the  Male  and 


Bones:  stronger,  larger,  heavier,  and 
more  rough. 

Head  and  extremities  preponderating 
over  the  trunk. 

Thorax:  more  elevated:  anterior  flat- 
tened ;  dorsal  vertebrae  higher ;  the 
ribs  passing  more  obliquely  down- 
wards, .... 

Sternum:  longer  and  flatter. 

Clavicles  :  more  strongly  curved,  long- 

-  er,  inclined  outwards;  the  angle 
with  the  sternum  obtuse. 

Abdominal  vertebra:  shorter;  and 
therefore  the  space,  ventral  cavity, 
between  them  and  the  chest  is 
likewise  shorter. 

Pelvis:  narrower,  higher.  Proinon- 
torium  more  pointed.  Crista  lliaca 
more  sigmoidal  and  curved,  drcus 
pubis,  angular.  The  acetabula 
closer  to  the  axis  of  the  body, 
therefore  the  gait  less  rolling. 


Sacrum :  narrower ;  Coccyx  broader. 

Extremities:  longer,  the   inferior  less 
converging. 

Cranial  and  facial  cavities,  with  ex- 
ception of  orbits,  larger. 
Canalis  spinalis,  narrower. 


of  the  Female  Skeleton. 

Shorter,  thinner,  lighter,  and  more 
smooth. 

Trunk  relatively  larger  than  head 
and  extremities. 

Chest  smaller,  more  barrel-like,  far- 
ther removed  from  the  pelvis; 
before  roundish;  dorsal  vertebrae 
and  ribs  shorter;  the  last  more 
horizontal. 

Sternum  shorter. 

Clavicles  straighter,  more  inclining 
outwards;  the  angle  with  the 
sternum  almost  a  right  angle. 

Higher.  Abdominal  cavity  more 
spacious. 


Wider  and  shorter.  Hip  bones  flat- 
ter, superior  border  standing  more 
erect.  Symphysis  less  elevated. 
Distance  between  it  and  the  Tu- 
bcrosit.  Ischii  greater;  between  it 
and  the  acetabula,  arcus  pubis, 
vaulted.  Foramen  obturator,  tri- 
angular. 

Broader;  Coccyx  narrower,  more 
moveable,  less  projecting. 

Shorter,  the  inferior  converging  to  the 
knees;  the  Trochanters  broad  and 
more  separated. 

Mouth  and  nose,  together  with  orbits, 
smaller;  teeth  smaller. 

Canalis  spinalis  more  spacious. 


ARTHROLOGIA. 

OF  THE  ARTICULAR  EXTREMITIES  OF  THE  BONES,  AND  THEIR 
CONNECTION  BY  MEANS  OF  LIGAMENTS,  FORMING  JOINTS. 

SYNDESMOLOG1A. 


"  In  proportion  indeed  as  we  comprehend  the  principles  of  mechanics,  or 
of  hydraulics,  as  applicable  to  the  animal  machinery,  we  shall  be  satisfied  of 
the  perfection  of  the  design." — The  Hand.  Sir  C.  BELI. 


ARTHROLOGIA. 

LITERATURE. 

General  Anatomy. 

Art.  "  Articulation,"  in  Cycl.  of  Anat.  and  Phys. 
Cartilage.     Toynbee,  Mem.  on  the  Non- vascular  Tissues.     Phil.  Trans.,  1841, 

and  separately. 
Works  on  General  Anatomy. 
Cyc.  of  Anat.  and  Phys.,  art  "  Cartilage." 

Descriptive  Anatomy. 
B.  B.  Cooper.     A  Treatise  on  Ligaments,  1827,  4to.,  with  plates,  and  in  the 

"Lectures,"  &c. 

Works  on  Descriptive  Anatomy. 

Sell,  Sir  C.     "  On  the  Hand."     Bridgewater  Treatise. 
Mtmro.     "On  the  Bursae  Mucosae."     Fol.  1788—1783. 


97 


UO.  OF  THE  LIGAMENTS. 

In  the  union  of  the  articular  surfaces  of  bones  three  kinds  of 
accessory  organs  are  present  which,  in  Syndesmology,  are  treated 
of  in  common,  namely  ligaments,  synovial  capsules,  articular  car- 
tilage. 

For  a  description  of  the  manner  in  which  the  bones  form  joints, 
and  the  modes  of  their  association,  refer  to  page  30. 

a.  Ligaments  of  bones,  ligamenta,  aw&fapoi,  formed  of  firm 
and  flexible  fibrous  tissue,  consist  of  white  and  yellow  fasciculi  or 
cords  which  are  not  extensible  and  little  sensitive,  of  a  flat,  longi- 
tudinal, oval,  also  annular  or  angular  figure ;  they  lie  either  between 
the  bones,  or  on  their  external  circumference,  almost  inseparably 
attached  to  the  extremities  which  they  unite  together.     We  dis- 
tinguish the  following  forms: — 

1.  Proper  ligaments,  ligamenta  fibrosa  accessoria,  flat  cords. 

2.  Fibrous  capsules.  Kgg.  capsularia,  which  are  tendinous  cylinders,  attached 
by  their  openings  to  the  bones,  enclosing  th.3  Synovial  capsules  together 
with  the  Cartilages. 

Yellow  ligaments,  ligg.  flava,  assigned  to  a  particular  purpose,  do  not  belong 
to  these  tissues. 

b.  Synovial  capsules,  capsulse  s.  membranse  synoviales,  arlicu- 
lares,  thin,  translucent,  closed  sacs  of  serous  uniting  tissue  between 
the  articular  extremities  of  the  bones,  connected  externally  with 
the  surrounding  ligaments,  secreting  inside  a  thin,  serous  fluid,  or 
a  thick,  albuminous   Synovia,  drawing  out  into  threads,  which 
prevents  the   attrition  of  the  bones   upon   one   another.     Folds 
which  have  lying  between  them  small  masses  of  fat,  form  inter- 
nally the  falsely  so-called  Glandulse  Haversianse.     The  synovia 
is  not  secreted  by  them,  but  from   innumerable   blood-vessels, 
especially  upon  the  lateral  parts. 

c.  Articular  cartilage,  carlilagines  arliculares,  are  elastic  discs 
of  cartilage  tissue  which  are  present  in  all  cases  where  joints 
exist,  for  the  purpose  of  obviating  or  equalising  the  pressure  of 
the  bones  upon  one  another.     They  are  so -much  the  thicker,  the 
more  moveable  the  articulation,  particularly  at  the  circumference 
of  the  articular  cavity,  but,  in  the  centre  upon  convex  surfaces. 
We  distinguish: 

1.  Cartilage  connected  with  the  bones,  which  it  is  extremely  difficult  to 
separate  from  them,  and  the  free  surface  of  which   looks   into  the  articular 
cavity,  and 

2.  Free  articular  cartilage,  cartilagg.  interariiculares,  which  on  one  of  the 
two  surfaces  is  connected  with  the  articular   end  of  the  bones,  is  covered  by 
the  synovial  sao,  and  connected  on  the  borders  with  the  fibrous  capsule.    They 
are  from  £  to  f  of  a  line  thick,  and  are  only  present  in  very  moveable  articu- 

7 


98  SPECIAL  ANATOMY. 

lations.     They  are  named  Menisci,  fjwn,  from  their  Biconcavity.     The  carti- 
lage may  waste  away  by  attrition. 

3.  Fibrous  cartilages  of  the  osseous  joints,  are  generally  disc-shaped,  united 
closely  with  the  Periosteum ;  for  example,  symphysis  pubis,  or  annular  labra 
glenaidea  attached  to  the  borders  of  the  articular  fossse. 

111.  Connections  of  the  Vertebrae  with  each  other,  Jlrticulatio 
vertebrarum. 

a.  The  vertebral  bodies  are  united  with  each  other  by  a  close 
articulation,  amphiarthrosis.     The  articular  surfaces  which  are 

.the  superior  and  inferior  surfaces  of  each  vertebral  body,  are 
rather  concave,  do  not  immediately  touch,  but  lie  upon  one  another 
by  means  of: 

1.  The  ligg.  (cartilagines)  intervertebralia,  twenty  three  strong  lenticular  discs, 
consisting  of  concentric  fibrous  rings  which,  closer  in  the  periphery,  are  sepa- 
rated towards  the  centre,  the  interspaces  being  filled  by  a  yellow  jelly,  which, 
in  the  central  point,  becomes  hardened  into  an  elastic  osseous  nucleus.    Their 
vertical  diameter  varies ;  it  may,  for  example,  diminish  after  standing  long 
in  the  erect  posture.     In  youth  the  gelatinous  masses  are  softer  and  whiter 
than  in  old  age,  and  on  this  account  the  vertebral  column  is  less  moveable  in 

,the  latter  than  in  the  former.  The  vertebral  bodies  are  further  surrounded 
with  a  fibrous  sheath,  the 

2.  Lig.  longitudinale  anterius,  on  the  anterior  surface,  from  the   Tuberculum 
atlantis  aniicum  to  the  upper  part  of  the  os  Sarrum ;  above  narrow,  below 

•broad;  white,  membranous,  thicker  on  the  dorsal  than  upon  the  cervical  and 
lumbar  vertebrae;  consists  of  two  lateral  portions,  which  are  separated  in  the 
centre  by  a  series  of  openings,  for  vessels.  Below  it  mingles  with  the  fibres 
of  the  crura  of  the  Diaphragm  and  the  Aponeurosis  of  the  m.psoas;  above 
with  the  tendons  of  the  m.  long,  colli  and  rectus. 

3.  Lig.  longihtd.  postering,  on  the  posterior  surface,  on  the  anterior  of  the 
Canal,  spinalis,  thicker  and  narrower  than  2,  commences  upon  the  internal 
surface  of  the  pars  basil,  occip.;  the  superior  portion,  from   the  third  cervical 
vertebra,  is  particularly  distinguished  as  apparatus  ligamentosus,  terminates  in 
the  Canal.  Sacralis.     The  posterior  surface  is  connected  by  processes  with 
Dura  Mater,  the  anterior  with  the  ligam.  intervertebralia.     On  the  borders, 
passes  sinus  venosi,  in  the  centre,  between  the  ligament  and  the  vertebral  body, 
the  vence  vertebrales.     It  extends,  like  the  anterior,  upon  the  intervertebral  car- 
tilages, and  attaches  itself  firmly  to  them. 

b.  Connection  of  the   Processus  obliqui, — Jlrthrodia.     The 
articular  surfaces   are   covered   with  cartilage,  provided  with   a 
synovial  sac,  and  united  together  by  ligg-  capsularia. 

c.  Ligaments  of  the  Vertebral  arches : 

Ligg.  flava  s.  intercruralia,  filling  up  the  intervals  between  the  arches,  are, 
really,  higher  than  these,  thicker  in  the  lumbar  vertebra,  thickest  in  the  region 
of  the  Proc.  spinosi.  Attachment:  to  the  inferior  and  superior  border  of  two 
vertebrae,  as  the  one  lies  upon  the  other.  Anterior  surface  smooth,  separated 
from  the  Dura  Mater  by  areolar  tissue  and  Vv.  spinales.  Structure:  thick, 
vertical,  elastic  but  strong  fibres.  Use  :  to  assist  the  Dorsal  muscles  in  main- 
.taining  the  erect  posture  of  the  body. 


THE  LIGAMENTS. 


99 


d.  Ligaments  of  the  Spinous  processes : 

1.  Ligg.  interspinalia,  fill  tlie  spaces  between  the  Proc.  spinosi,  are  wanting 
in  the  neck,  muscles  existing  there,  are  triangular  on  the  Dorsal,  thick  and 
quadrangular  on  the  Lumbar  vertebrae. 

2.  Ligg.  apicum,  roundish,  from  the  apex  of  the  one  to  that  of  the  next, 
Proc.  spinosus ;  wanting  in  the  neck. 

3.  Lig.  nuchce,  cervical  ligament,  triangular,  continuation  of  the  Ligg.  apic. 
upwards,  from  the  seventh  cervical  vertebra  to  the  Spina  Occipit.  extern.,  re- 
ceiving vertical  elongations  from  the  fissure  between  the  proc  spinosi  of  the 
superior  cervical  vertebrae. 

e.  Ligaments  of  the  transverse  processes,  ligg.  intertransver- 
salia,  are  thin  strips  between  the  apices  of  the  transverse  pro- 
cesses, generally  only  on  the  Dorsal  vert.,  placed  here  for  the  m. 
levatores  costarum  et  multif.  spinse;   very  often  double. 

Movements  of  the  Vertebral  column:  1.  Forwards  [flexion]; 
2.  Backwards  [extension];  3.  Inclination  sideways;  4.  Rotation. 
The  cervical  portion  is  the  most,  the  dorsal  the  least  moveable. 

112.     Connection  of  the  Vertebral  column  with  the  Cranium, 
Jlrticulatio  capitis. 

a.  The  Atlas  with  the  Occiput: 

1.  Articular  connection — Ginglymus — between  Proc.  condyl- 
oidei  occipitis  and  Proc.  obliq.  super,  atlantis,  for  the  movements 
of  the  head,  forwards  and  backwards,  is  maintained  by : 
.  Ligg.  capsularia,  particularly  strong  anteriorly  and  externally,  broad,  yel- 
lowish circles  around  the  articular  processes,  between  which  a  wide  loose 
synovial  capsule. 

2.  Ligaments: 

a.  Ligam.  obturatarium  s.  latum  anterius,  strong  and  elastic,  extends  between 
the  superior  border  of  the  Atlas  and  the  pars,  basilar.  occipit.;  before  it  in  the 
centre  lies 

0.  Lig.  rectum  s.  lacertus  (Weitbrechti)  medius,  a  thick  band,  from  tubercul. 
antic,  atlant.  to  the  Proc.  basilaris  occipitis,  strengthening  the  before  mentioned 

y.  Lig.  obturatorium  posterius,  thin,  broad,  and  slack,  from  the  posterior  arch 
of  the  Atlas  to  the  posterior  circumference  of  the  foram.  magn.,  laterally  per- 
forated by  the  Art.  vertebralis. 

*.  Lig.  laterale,  cord-like,  from  the  basis  of  the  Proc.  transvers.  atlant.  to  the 
proc.  jugular,  occipit.,  forms  with  a  similar  from  the  petrous  bone,  a  ring,  for 
vena  jugular,  intern.,  Carotis  intern.,  n.  Hypoglossus,  vagus,  glossopharyng.,  access. 
Willisii. 

b.  The  proc.  dentiformis  with  the  occipital  bone,  only  by  liga- 
ments. 

1.  Ligg.  lateralia  proc.  dentiformi* s.  alaria  Maucharti,  very  strong  and  short, 
from  the  sides  of  the  apex  of  the  odontoid  process  outwards  to  a  fossa  on  the 
inner  side  of  each  Condyle.     They  prevent  too  great  lateral  movement  of  the 
head. 

2.  Lig.  suspensorium  dentis,  from  the  centre  of  the  apex  to  the  anterior  border 
of  the  great  foramen,  it  thus  forms  a  figure  like  an  inverted  letter  £,  is  quad- 
rangular, and  affixed  to  the  Odontoid  process. 


100  SPECIAL  ANATOMY. 

113.  c.  The  Atlas  with  the  Epistropheus,  or  vert,  dentata. 

1.  Rotary  articulation — trochoides — between  the  anterior  arch 
of  the  Atlas  and  the  Odontoid  process  which  last  describes  on 
each  side  within  a  ring,  anteriorly  osseous,  posteriorly  ligamentous 
(Lig.  transvers.),  the  fourth  part  of  a  circle,  and  prevents  every 
other  movement  but  rotation  which  is  performed   by  the  proc. 
obliq.  inferr.  atlant.  and  superr.  epistroph.,  as  the  atlas  and  cra- 
nium move  thereon  as  one  piece. 

2.  Between  proc.  obliqui  atlant.  and  epistrophei  a  free  articu- 
lation— arthrodia — since  the  circular  surfaces  of  both  planes  lie 
horizontal,  and  are  provided  with  a  wide  articular  and  synovial 
capsule. 

3.  Lig.  transversvm  atlantis,  very  thick  and  dense,  flat,  extending  horizon- 
tally behind  the  Odontoid  process,  from   one  lateral  mass  of  the  atlas  lo  the 
other.     The  anterior  concave  surface  is  in  apposition  with  the  posterior  surface 
of  the  Odontoid  process,  which  is  covered  with  cartilage.     [In  the  centre  of 
this  transverse  ligament  there  is  a  portion  of  cartilage,  and  a  very  delicate 
synovial  capsule  is  attached  around  the  articular  surfaces.]     From  the  supe- 
rior border  an  appendix  passes  upwards  to  the  anterior  border  of  the  foram. 
magnum ;  a  similar  from  the  inferior  border  to  the  posterior  surface  of  the 
Corpus  episirophei;  thence  arises  a  ligam.  crudatum. 

114.  Articulation  of  the  lower  jaw,  articulalw  maxillaris,  a 
free  joint,  formed 

1.  By  the  elongated  proc.  condyloid.  of  each  half  of  the  lower 
jaw,  covered  with  cartilage,  which  is  directed   rather  obliquely 
from  without  to  within  from  before  to  behind  ;  and 

2.  By  the  deep  and  capacious/ossa  glenoidalis  of  the  temporal 
bones,  the  anterior  part  of  which,  to  ihejissura  Glaseri,  is  alone 
covered  with  cartilage,  and  is  an  articular  cavity.     The  anterior 
wall  forms  the  convex  transverse  root  of  the  proc.  zygomalic., 
and  upon  it  the  proc.  condyloid. ,\ikew\se  convex, rolls  backwards 
and  forwards. 

Between  the  articular  surface  lies  a  free 

1.  Menifcus  [or  interarticular  cartilage],  firmly  attached  below,  to  the  Con- 
dyle,  behind,  to  the  glenoid  cavity,  dividing  the  articular  cavity  into  a  superior 
and  inferior  space. 

2.  Ligam.  capsulare  extends  from  the  border  of  the  fossa  glenoid.  to  the  cir- 
cumference of  the  Condyle.     Above  and  below  the  cartilage  lies  a  rynovial 
capsule;  the  superior  is  wider,  and  proceeds  from  the  boundary  of  the  Cavit. 
glenoidal.  and  tuberc.  articulare,  the  inferior  from  <:oUum  condyli. 

3.  Lig.  later  ale  exlernum,  from  the  tubercle  at  the  root  of  the  Proc.  zygomat. 
to  the  outer  fide  of  the  Collum  Condyli,  triangular  and  broad ;  it  covers  the 
outer  side  of  the  joint. 

4 .  Lig.  lateraleinlernurn,  from  Spina  angularis  of  the  Sphenoid  bone  to  the  osseus 
lam?ll(^  on  the  inner  side  of  the  foram.  tnaxill.  post.,  separates  the  dental  vessels 
arid  nerves  from  \bemusr.  plerygoid.,  is  thin  and  broad,  contributing  little  to  the 
strength  of  the  joint;  likewise  the  so-called  Lig.  s^ylo-maxillare,  merely  fascia. 


THE  LIGAMENTS.  101 

Movements  of  the  lower  jaw;  a.  downwards.     The  condyles, 
together  with   the  menisci,  roll  from  behind,  forwards ;  Ligam. 
later,  extern,  is  stretched;  Lig.  lat.  intern,  remains  unchanged. 
/Drawing  down  the  lower  jaw  too  strongly,  as  for  example  in  gap- 
f  ing,  may  produce  luxation,  that  is,  a  slipping  of  the  condyle  out 
of  the  f ass.  glenoidal.  into  the  zygomatic  fossa. 
•    b.  Upwards,  that  is,  in  closing  the  mouth.     The  movements  of 
the  condyle  the  reverse  of  a.     Luxation  backwards  is  prevented 
by  the  anterior  wall  of  the  auditory  meatus,  to  which  point  the 
condyles  may  roll,  for  example,  in  edentulous  old  age. 

c.  Forwards  (and  backwards)  horizontally:  the  articular  head 
comes  below  the  transverse  root  of  the  proc.  zygomat.     But  it 
must  be  preceded  by  the  movement  downwards.     AH  the  liga- 
ments  are  stretched.    In  too  great  extension  the  coronoid  process 

^i  is  opposed  by  the  upper  jaw,  and  farther  luxation  rendered  iin- 
.1   possible. 

d.  From  side  to  side.     The  condyle  of  one  side  passes  side- 
^  ways  from  its  cavity,  stretching  its  ligaments ;  that  of  the  other 

j  sinks  more  deeply  into  its  articular  cavity,  where  a  luxation  in- 
wards is  prevented  by  proc.  styloideus  and  its  sheath,  as  well  as 
by  proc  spinosus. 

The  movements  c  and  d  are  more  limited  than  a  and  b. 

115.        Connections  of  the  Thoracic  cavity,  Chest. 
I.  Vertebrae  with  the  ribs,  Jlrticul.  costo-vertebralis. 

a.  Capitulum  costse  has  a  divided  articular  surface,  which  lies 
J     in  \\iefoveas  costales,  formed  by  the  bodies  of  two  dorsal  vertebrae, 

unites  with  the  car/if.  mterverfebr.,zm\  forms  a  free  articulation, 
enarthrosis,  not  ginglymus.  Its  synovial  capsule  is  single  on 
the  first,  eleventh  and  twelfth  ribs,  double  on  the  rest;  articular 
capsule  incomplete.  Instead  of  it : 

1.  Lig.  capituli  anlerius  s.  radialunt,  stellate  on  the  anterior  surface  of  the 
joint 

2.  Lig.  capifuli  inferarliculare,  on  the  second  and  to  the  tenth  ribs,  from 
the  crisiu  of  capituli  to  the  carliL  inlerarlic.  /  flat,  oval,  and  separating  the 
two  synovial  capsules. 

b.  Tuberculum  costae  has  a  convex   articular  surface  which 
unites  with  one  concave,  on  the  proc.  transvers.  in  a  close  joint. 
Moreover,  ligaments  pass  from  collum  costse  to  the  proc.  trans- 
versi. 

1.  Synovial  capsule. 

2.  Lig.  tubcrculi  s.  transversariurn  posterius,   quadrangular,   behind   the 
joint ;  from  the  apex  of  the  proc.  tran&vers.  to  the  posterior  surface  of  tne 
Tu'iercul.  CDS' as  of  the  first  to  the  tenth  ribs  inclusive. 

3.  Lig.  transversarium-intermedium,  from   the  anterior  surface  of  the  proc. 
transv.  to  the  postarior  of  the  collum  costee ;  very  strong. 


102  SPECIAL  ANATOMY. 

4.  Lig.  transversarium  internum,  rhombic,  from  the  inferior  border  of  the 
proc.  trans,  of  the  vertebra  next  above  to  the  superior  border  of  the  Cottum, 
wanting  on  the  twelfth  rib ;  divides  the  posterior  and  anterior  branches  of  the 
Intercostal  nerves. 

5.  Lig.  transversarium  intern.,  triangular,  weak,  descends  from  the  root  of 
the  proc.  transvers.  of  the  vertebra  next  above  to  the  posterior  surface  of  the 
collum  costce,  close  to  the  capitulum ;  it  is  wanting  on  the  first,  eleventh,  and 
twelfth  ribs. 

116.  II.  The  ribs  with  the  sternum,  articulatio  sterno-costalis,     + 
Amphiarthrosis.     The  cartilages  of  the  ribs  which  are  firmly  con-  j> 
nected  with  the  bone,  and  possess  no    farther  external  means  of  * 
union  than   the  common  Periosteum,  Perichondrium,  are  inti-  ^ 
mately  attached  in  the  incisura.  costal,  sterni  by  Synovial  cap- 
sules and  stellate  ligaments,  from  the  second  to  the  seventh  rib. 
The  fifth  to  the  ninth  ribs  have,  at  their  place  of  contact,  delicate      ^ 
synovial  capsules.     The  first  rib   cartilage  is,  generally,  closely  ^ 
united  with  the  sternum. 

Ligaments :  1 .  Lig.  interarticulare,  of  the  second  to  the  fifth  ribs,  divides 
the  double  synovial  capsules. 

2.  Lig.  radiatum  externum,  proceeds  from  a  true  rib  cartilage  of  one  side  to 

the  one  next  above  of  the  other,  crosses  also  upon  the  centre  of  the  Sternum,    *••" 
and  loses  itself  in  the  Periosteum  and  the  tendinous  expansion  of  the  great 
pectoral  muscles.    In  a  like  manner  is  arranged  the  less  strong  Lig.  rad.  intern. 
upon  the  posterior  surface  of  the  Sternum. 

3.  Ligg.  coruscantia,  brilliant  bundles  of  fibres  between  the  third  to  the 
tenth  rib  cartilages,  to  fill  up  the  spaces  between  the  cartilages  of  the  ribs. 
Vide  m.  intercostales. 

4.  Ligg.  proccssus  ensiformis,  proceed  from  the  inferior  border  of  the  sixth  and 
seventh  rib  cartilages  over  the  centre  of  the  ensiform  process  and  attach  it  to 
them. 

5.  Membrana  sterni  propria,  covers  the  external  and  internal  surface  of  the 
Sternum,  and  consists  of  the  fibres  of  Periosteum  crossing  each  other. 

Movements  of  the  chest. 

1 .  Expansion,  upon  inspiration,  by  elevation  of  the  ribs,  whereby  the  an- 
terior extremities  of  the  ribs  move  forwards,  the  lateral  outwards,  and  the       - 
diameter  of  the  thorax  is  increased  from  before  to  behind  and  transversely. 

In  forcible  inspiration  the  Sternum  also  is  elevated.     The  first  rib  remains 
immoveable. 

2.  Contraction,  upon  expiration,  depends  upon  the  falling  back  of  the  ribs 
and  these  parts,  from  their  weight,  and  the  elasticity  of  the  cartilage,  as  well 
as  in  consequence  of  the  direct  action  of  the  expiratory  muscles. 

117,  Connections  of  the  Pelvis. 

a.  The  Ossa  coxarum  with  each  other.  Symphysis  ossium 
pubis.  Pubic  symphysis  with  : 

1.  Lig.  (s.  cartilago)  interosseum  pubis,  a  prismatic,  fibro-cartilage,  as  on  the 
bodies  of  the  vertebrae,  half  an  inch  broad  in  front,  covered  by  crossed  fibres 
and  by  Lig.  pubis,  s.  arcuatum,  supcrius,  transversely  from  one  tuberculum  pubis 
to  the  other. 


THE  LIGAMENTS.  103 

2.  Lig.  annttlare,  consisting  of  transverse  fibres,  the  rings  passing  round  the 
borders  of  the  articular  surfaces. 

3.  Lig.  arcuatum  inferius  s.  triangulare  or  sub-pubic,  beneath  the  symphysis, 
triangular,  continuation  of  the  Lig.  inteross.,  forms  the  superior  border  of  th6 
pubic  arch;  proceeds  from  one  ramus  descend,  pub.  to  the  other. 

b.  The  ram.  coxarum  with  the  vertebral  column,  symphysi* 
sacro-iliaca. 

The  articular  surfaces  of  the  Sacrum  and  Ilium,  superficies 
auriculares,  covered  with  cartilage  and  with  a  thin  Synovial  cap- 
sule, which  in  children  and  pregnant  women  is  more  distinct,  are 
united  by  a  slight  layer  of  fibro-cartilage  with  gelatinous  sub- 
stance, and  form  an  amphiarthrosis.  Contributing  to  strengthen 
the  articulation  there  are  : 

1.  Ligg.  sacro-iliaca  vaga  anteriora,  short,  transverse  and  oblique  from  the 
superior  surface  of  the  Sacrum  to  the  internal  of  the  Ilium,  they  blend  with 
the  menib.  oss.  sacri  propria. 

2.  Ligg.  sacro-iliaca  vaga  posteriora,  short,  crossed,  filling  up  the  fossa  be- 
tween the  posterior  surface  of  the  Sacrum  and  tuber  oss.  ilium. 

3.  Ligg.  pelvis,  s.  ileo-sacra  postica,  two;  thick,  on  the  posterior  side  of  the 
pelvis  ,—longum  arising  from  spina  ilei  poster,  super.  • — breve  arising  from  spina 
Ueipost.  infer.     Both  are  attached  to  the  proc.  transversus  of  the  third  and  fourth 
sacral  vertebrae.     Sometimes  three  lateral  bundles  pass  from  the  hip-bone  to 
the  proc.  transfers,  of  the  first  and  second  sacral  piece. 

4.  Lig.  ilco-lumbalia  s.  pelvis  anterior;  lies  over  the  sacro-Uiac  symphysisj 
springs  from  proc.  transv.  of  the  fifth  or  fourth  lumbar  vertebra.  Lig.  superius 
is  fixed  to  the  posterior  part  of  the  crista  Ilei.     Lig.  inferius  is  attached  broad 
upon  the  superior  surface  of  the  Sacrum  and  the  internal  of  the  Ilium,  close 
to  the  spina  ilei  poster,  super. 

c.  Of  the  sacrum  and  coccyx — a  symphysis,  which  often  ossi- 
fies ;  in  very  moveable  coccyges,  a  synovial  capsule.     Between 
the  articular  surfaces  a  delicate  layer  of  fibro-cartilage. — Liga- 
ments. 

1.  Ligg.  sacro-coccygea  postica  longa.  from  the  border  of  the  exit  of  the  Co- 
nalis  tacralis,  which  they  close,  diminishing  upon  the  posterior  surface  of  the 
coccyx,  for  m.  gluten  maximi. 

2.  Ligg.  sacro-coccygea  post,  brevia,  below  the  last,  passing  from  the  cornua 
of  the  Sacrum  to  that  of  the  coccyx ;  are  often  ossified. 

3.  Ligg.  sacro-coccygea  antica,  from  the  apex  of  the  sacrum  to  that  of  the 
coccyx,  in  front;  often  wanting. 

4.  Membr.  ossis  sacri  propria,  covers  the  anterior  surface  of  the  Sacrum,  & 
above  covered  by  lig.  hngitudinale  anterius. 

d.  Ligaments  for  the  purpose  of  limiting  the  pelvic  cavity. 

1.  Lig.  obturatorium,  consists  of  aponeurotic  bundles  which  cross  in  all  di- 
rections, closing  an  egg-shaped  opening ;  it  is  perforated  at  its  superior  margin 
by  a  foramen  for  art^  ven^  nerv.  obturator,  and  serves  to  give  attachment  to  the 
m.  obturatores  extertius  et  internus. 

2.  Ligg.  sacro-ischiadica  majus  et  minus. 

a.  Majus  s.  post.  s.  tuberoso-sacrum  arises  from  the  internal  lip  of  the  tuber 


104  SPECIAL  ANATOMY. 

isckti,  and  with  a  sickle-shaped  extension,  folx  ligamentosa,  from  ramus  ascendens 
oss.  ischii,  by  which  arises  a  groove  for  art.,  ven,,  et  nerv.  pudend.  commun.,  and 
thus  prevents  pressure  in  the  sitting  posture ;  passes  obliquely  upwards  and 
backwards,  and  is  attached  broad  to  the  margin  of  the  sacral,  even  to  the  most 
superior  of  the  coccygeal,  pieces;  serves  for  the  attachment  of  the  glufeeus 
maximus. 

b.  Minus  s.  ant.  s.  spinoso-sacrum,  lies  before  a,  springs  from  spina  Ischii, 
I>asses  inwards  and  backwards  and  blends  with  a-  serves  for  the  attachment 
of  the  muscles  levator  ani,  coccygeus.  From  the  manner  in  which  the  Ligg. 
ischiad.  limit  the  incisurce  ischiadicce  below,  two  foramina  arise,  of  which 

1.  The  superior,  incirura  major,  large,  almost  triangular,  is  in   great  part 
closed  by  the  mm.  pyriformis  et  coccygeus,  together  with  areola  or  uniting  tissue, 
and  allows  the  passage  through  it  of  the  Nervi  et  vasa  ischiadica,  glutaea  et 
pudenda ; 

2.  The  inferior,  incisura  minor,  small,  between  spina  et  tuber  Ischii,  for  m. 
obturator  internus.     Nerv.  et  vasa  pudenda  also  pass  through  it. 

118.          Connections  of  the  Superior  Extremities. 

I.  The  Shoulder-bones. 
A.  Of  the  Clavicle  with  the  Sternum,  Jlrticul.  Sterno-clavicularis. 

Arthrodia.  The  articular  surface  of  the  clavicle  extends,  be- 
fore and  behind,  beyond  that  of  the  sternum,  and  the  last,  inci- 
sura clavicularis  manubrii,  likewise  inwards  and  outwards  over 
the  clavicle.  This  bone  is  also  firmly  united  with  the  first  rib. 

1.  Lig.  capsulare,  round  about  the  circumference  of  the  two  articular  sur- 
faces; before  loose,  therefore  on  this  side  displacement  is  more  easy  than 
behind;  contains:  an  interarticular  cartilage  with  an  external  loose  and  an 
internal  synovial  capsule,  below,  connected  with  the  cartilage  of  the  first  rib, 
above  and  behind,  with  the  clavicula. 

2.  Lig.  interclaviculare,  unites  the  internal  extremity  of  one  clavicle  with 
that  of  the  other,  as  it  passes  transversely  over  the  incisura  semilunarismanubrii, 
and  indeed,  lies  rather  behind  it. 

3.  Lig.  costo-claviculare  s.  Rhomboideum,  a  dense  fibrous  bundle  ;  proceeds, 
obliquely  backwards  and  upwards,  from   the  superior  margin  of  the  first  rib 
cartilage  to  the  inferior  and  sternal  end  of  the  clavicula.     An  articular  surface 
for  the  reception  of  the  clavicula  is,  generally,  present  on  the  first  costal 
cartilage. 

The  movements  of  the  shoulder  depend  upon  these  articular 
connections. 

a.  Movement  of  the  shoulder  upwards.     In  this  the  sternal 
surface  of  the  clavicula  glides  downwards,  upon  the  articular  sur- 
face of  the  sternum,  the  Lig.  inter  dav.  is  relaxed  ;  the  cartilage 
of  the  first  rib  prevents  the  escape  of  the  clavicula  downwards. 

b.  Downwards. — The  sternal  end  of  the  clavicula  glides  up- 
wards ;  the   articular  surfaces  of  the   clavicle    and  first  rib  are 
strongly  pressed  upon  one  another,  whereby  the  art.  subclavia  is 
compressed. 


THE  LIGAMENTS.  105 

c.  Backwards. — The  sternal  extremity  of  the  clavicula  glides 
forwards;  the  anterior  portion  of  the  Lig.  capsulare  is  stretched, 
often  even  to  laceration,  and  then  luxation  of  the  clavicle  takes 
place  forwards. 

d.  Forwards. — The  sternal  end  of  the  clavicula  glides  back- 
wards ;  the  posterior  portion  of  the  Lig.  capsulare  and  of  the 
Lig.  inter  clavicul.  stretched. 

e.  In  circumduclion  the  movement  is  very  limited,  and  it  is 
resigned  to  the  upper  arm. 

119.  B.  Of  the  clavicula  with  the  scapula,  Artie,  acromio- 

davicularis. 

Amphiar  thro  sis. — The  articular  surfaces  are  elliptical,  even, 
and  lie  obliquely  to  one  another;  that  of  the  clavicle  looks  rather 
downwards  and  outwards,  that  of  the  acromion  upwards  and 
inwards;  above,  between  them,  but  not  always,  we  find  a  free 
cartilage,  and  a  synovial  capsule. 

1.  Lig.  capsulare  (externum)  is  attached  closely  with  the  following. 

2.  Lig.  claviculo-acromiale,  proceeds  from  the  surface  and  the  posterior  bor- 
der of  the  acromion  to  that  of  the  external  extremity  of  the  clavicula  ;  is  above 
very  strong. 

Ligaments  between  proc.  coracoideus  and  clavicula  artic. 
coraco-clavicularis. 

3.  Lig.  posierius  s.  conoideum,  triangular,  vertical  from  the  root  of  the  coracoid 
process,  expanding  as  it  ascends  to  the  tubercle  upon  the  posterior  border  of  the 
external  termination  of  the  Clavicula. 

4.  Lig.  anterius  s.  trapezoideum,  oblique  from  the  inferior  border  of  the 
root  of  the  Proc.  coracoidy  to  the  inferior  surface  of  the  acromial  extremity  of 
the  Clavicle;  close  before  3.;  both  of  them  are  loose.  •$»•!:> 

Ligaments  of  the  shoulder-blade. 

1.  Lig.   Coraco-acromiale,  is  attached  broad  to  the  external  border  of  the 
Proc.  coracoid,  and  by  an  apex  to  the  anterior  blunt  point  of  the  Jlcromion, 
filling  up  the  space  between  the  two,  and  forming  a  roof  over  the  upper 
arm. 

2.  Lig.  transvcrsum,  thin,  flat,  passes  from  the  root  of  the  Proc.  coracoid, 
across  the  incisura  scapula,  with  which  it  forms  a  foramen,  for  nero.  suprascapu- 
laris  et  ven.  trans,  scap. 

120.  II.  Connection  of  Scapula  with  Humerus,  Artie.  Scapu- 

lo-humeralis  s.  Artic.  humeri,  Shoulder-joint, 

is  the  most  free  of  the  whole  body,  the  type  of  Enarthrosis. 
a.  Articular  surfaces. 
1 .  Fossa  glenoidalis,  superficial,  concave,  oval,  directed  outwards. 


106  SPECIAL  ANATOMY. 

2.  Caput  humeri  =  £  of  a  sphere,  the  axis  of  which  forms  a 
very  oblique  angle  with  the  Corpus  Humeri.  Both  are  covered 
with  cartilage. 

b.  Lig.  s.  labrum  glenoideum,  a  ring  on  the  margin  of,  and  for  the  purpose  of 
deepening,  the  articular  cavity  which  however  does  not  enclose  the  entire 
articular  head ;  consists  of  fibrous  tissue.     Vide  Interarticular  Cartilages. 

c.  Lig.  capsulare  humeri,  from  the  margin  of  the   articular  cavity  to  the 
Collum  humeri  and  the  two  Tubercula,  forming  a  bridge  over  the  groove  be- 
tween them  and  the  tendon  of  the  biceps;  a  loose  spacious  capsule  which 
above  has  one  to  two  openings,  by  which  a  communication  is  established  be- 
tween the  synovial  capsule  of  this  joint  and  the  bursee  of  the  mm.  infraspinal. 
and  subscapular.     Is   protected,  below,  in  the  axilla,  by  the  areolar  tissue  be- 
tween the  tendons  of  the  mm.  subscapular.  and  teres  minor ; — above  and  exter- 
nally by  the  tendons  of  the  in.  supraspinatus  ; — before,  by  the  m.  subscapularis  ; 
— behind,  bv  the  tendons  of  the  mm.  supra-,  infra-spinatus,  teres  minor  • — above, 
even  strengthened  by  a  Lig.  accessorium  of  the  Proc.  cora(oid,  and  by  the  ten- 
don of  the  long  liead  of  the  Biceps  on  the  anterior  aspect ; — lastly,  by  the 

d.  Arch  or  vault,  which  is  formed  over  the  joint  by  the  acromion,  Proc. 
coracoid.,  Lig.  coraco-ucrotniale,  and  m.  delloideus. 

Movements : 

1.  Forwards  and  backwards. — The  head  of  the  humerus  rolls 
upon  its  own  axis.     The  escape  of  the  head  anteriorly  is  pre- 
vented by  the  coracoid  process.     The  scapula  performs  at  the 
same  time  a  movement  of  rotation. 

2.  Outwards, — abduction. — The  head  of  the  humerus  glides 
from  above  downwards,  and  presses  upon  the  inferior  portion  of 
the  capsule,  the  upper  arm  may  even  be  conveyed  to  the  skull ; 
the  scapula  remains  immoveable. 

3.  Inwards* — adduction. — The  arms  crossed  over  the  chest. 

4.  Rotation  outwards  and  backwards,  inwards  and  forwards  is 
of -lit  tie  extent. 

121.     Connection  of  the  Upper  with  the  Fore-arm,  Artizul. 
cubito-humeralis.     Hinge-joint. 

Articular  surfaces. 

a.  Of  the  Humerus : 

J.   Trochlea. 

2.  Rotula. 

3.  Fossa  cubital,  post.,  for  Olecranon. 

4.  „         „       ant.,  forjoroc.  Coronoid. 

b.  Of  the  Fore-arm : 

1.  Fossa  sigmoid.  ulnse,  for  the  trochlea. 

2.  Cavitas  glenoid.  radii,  for  rolula. 


THE  LIGAMENTS.  107 


Ligaments : 

1.  Lig.  capmlare  cubiti  from  the  inferior  extremity  of  the  Humerus  to  the 
Olecranon,  the  fossa  sigmoid.  ma/or,  proc.  coronoid.,  and  Kg.  annidare  radii; 
loose  and  wide,  behind  and  on  the  sides  weaker  than  before ;  behind,  the  ten- 
don of  the  Triceps  muscle. 

2.  Lig.  laterale  internum,  three  portions  from  the  internal  condyle  of  the  hu~ 
merits  to  a  point  below  the  Coronoid  process  of  the  Ulna  on  the  inner  side. 

3.  Lig.  laterale  externum,  triangular,  from  the  external  condyle  to  the  lig.  an- 
nulare  radii,  below  the  tendon  of  the  Supinator  brevis.     The  Synovial  Capsule 
lies  behind  the  anterior  wall  of  the  capsular  ligament,  reflected  from  the  fossa 
anterior  to  the  fossa  posterior,  where  it  is  the  widest ;  it  terminates  below  in 
a  blind  prolongation  on  the  inner  margin  of  the  lig.  annulare  radii. 

Movements : 

1.  Flexion,  JJexio.      The    entire   fore-arm    moves   upon   the 
Trochlea  and  rotula  humeri  from  behind,  forwards,  so  that  the 
finger-points  may  touch  the  mouth.     Proc.  coronoid.  lies  in  the 

fossa  anterior,  and  prevents  farther  flexion. 

2.  Extension,  extensio. — The  reverse  of  the  preceding,  from 
before  backwards,  until  the  axes  of  the  fore-arm  and  humerus  lie 
in  the  same  line.    Proc.  olecrani  lies  in  the  fossa  posterior,  and 
prevents  farther  extension. 

19.9..         Connections  of  the  Ulna  with  the  Radius. 

A.  Articulatio  radio-cubit alis  superior. — Rotatio. 
Articular  surfaces : 

1.  On  the  Radius,  circumferentia  articularis  capituli. 

2.  On  the  Ulna,  fossa  sigmoidea  minor,  elongated  from  before 
to  behind,  forms  the  osseous  portion  of  the  ring  in  which  Capitul. 
radii  rolls. 

Ligaments:  1.  Lig.  annulare  radii,  strong,  dense,  three-fourths  of  a  ring, 
surrounds  a  synovial  capsule  and  capitul.  radii;  attaches  itself  to  the  anterior 
and  posterior  extremity  of  the  fosssa  sigmoid.  minor  and  unites  externally  with 
lig.  laterale  externum;  above,  with  lig.  capsulare  cubiti;  is  anteriorly  much 
thinner,  and  therefore  easily  lacerates. 

2.  Lig.  teres  s.  chorda  transversalis  cubiti,  Weitbrecht,  passes  obliquely  from 
below,  outwards,  from  the  most  external  aspect  of  the  Proc.  Coronoid.  to  the 
inferior  portion  of  the  Tuberost.  (bicipit.')  radii;  compensates  for  the  lig.  inter- 
osseum  at  the  superior  part. 

19.9.  hi*.     B.  Articulatio  radio-cub  italis  inferior. — Rotatio. 
Articular  surfaces : 

1.  On  the  radius:  incisura  ulnaris. 

2.  On  the  ulna:  capitulum,  §  of  the  external  circumference. 

Ligaments :  1.  Lig.  capsulare  sacciforme,  broad  and  loose,  proceeds  from  the 


108  SPECIAL  ANATOMY. 

boundary  of  the  incisura  semilunaris  to  that  of  the  Capitulum  Ulna  and  the 
Carlilago  triangularis  ;  lies  beneath  lig.  capsulare  carpi  et  antibrachii. 

2.  Cartilago-triangularis  lies  with  its  apex  in  the  angle  between  Capitul.  et 
Proc.  styloidem  ulnce,  with  its  base  on  the  inferior  border  of  the  incisura  semi- 
lunaris, and  fills  up  the  interval  between  the  two  bones;  its  apex,  lig.  subcru- 
entum,  unites  with  the  proc.  styloid.  Ulnce  ;  over  it  a  syriovial  capsule. 

Appendant :  3.  Lig.  interosseum.  A  membrane  in  the  space  between  the 
central  pieces  of  the  radius  and  the  ulna,  from  the  Crista  radii  to  the  Crista 
ulna ;  serves  for  attachment  of  muscles,  extensor  brevis,  abductor  and  flexor 
longus  pollicis,  extensor  indicis  proprius,  flexor  digit,  comm.  profund. ;  has  above 
and  below  spaces  through  which  the  interossea.1  vessels  and  nerves  perforate, 
and  for  m.  supinator  brevis.  The  fibres  of  the  ligament  cross  from  the  radius 
inwards  and  downwards. 

Movements : 

Rotation ;  the  radius  alone  moves.  1.  Forwards, — pronation. 
a.  At  the  superior  radio-ulnar  articulation.  The  internal  portion 
of  the  capitul.  radii  rolls  from  before  backwards;  its  escape  is 
prevented  by  the  small  projection  on  the  foss.  sigmoid.  min.; 
but,  however,  it  sometimes  happens,  particularly  in  children  while 
falling,  at  the  same  time  that  the  hand  is  held.  b.  At  the  inferior 
radio-ulna  art.  The  fossa  semilunaris  radii  rolls  backwards  and 
forwards;  should  the  capsular  ligament  lacerate,  the  capitulum 
ulnse  passes  out  backwards. 

2.  Backwards, — Supination.  a.  At  the  superior  articulation: 
The  capit.  radii  rolls  from  behind,  forwards,  and  comes  in  contact 
with  the  anterior  projection  of  the  Fossa  sigmoidea  minor. 
Luxation  is  very  rare.  b.  At  the  inferior  articulation :  Fossa 
semilunaris  radii  rolls  from  before,  backwards;  the  capitulum 
ulnae  may  escape  forwards,  if  the  capsular  ligament  is  lacerated. 

In  pronation  the  once  parallel  body  of  the  radius  is  drawn 
over  the  ulna,  and  crosses  it,  since  the  superior  extremity  remains 
on  the  outer  side,  and  the  inferior  passes  to  the  inner.  The  in- 
terosseous  ligament  is  relaxed. 

In  supination  the  radius  returns  back  again  into  its  parallel 
position,  with  respect  to  the  ulna,  and  the  ligam.  interosseum  is 
stretched. 

123.   V.  Connection  of  the  Fore-arm  with  the  Hand, 
Jirticulatio  carpi. 

The  wrist-joint,  articulalio  carpi,  forms  a  free,  ball  and  socket 
joint. 

Articular  surfaces:  1.  Of  the  radius  and  ulna,  concave,  elon- 
gated transversely.  2.  Of  the  carpus — os.  naviculare,  lunatum, 
et  cuneiforme — forming  a  head. 

That  portion  of  the  articular  surface,  belonging  to  the  Ulna, 


THE  LIGAMENTS.  109 

contributes  only  |  to  the  whole,  and  nnites  with  the  os.  cuneiforms 
by  the  cartilago-triangular  (vide  ante),  but  not  immediately.  On 
both  sides  of  the  articular  surface  of  the  fore-arm  we  find  proc. 
styloidei. 

Ligaments :  1.  Lig.  capsulare  anlibrnchio-carpalis,  Gunther,  before  much 
stronger  than  behind,  covers  the  Kg.  capsul.  saccifnrme  (vide  antt).  Attach- 
ments :  the  Dorsal  surface  of  the  radius  and  Carfif.  frianyul.  The  Dorsal 
surfaces  of  the  three  carpal  bones.  This  is  strengthened  by  lig.  rhoml>oideum 
s.  radio-limato-hamutum  dursale ,-  on  the  palmar  surface  completed  by  liga- 
ments, which  pass  from  the  radius  to  os  lunatum,  naviculare,  and  proc.  sly- 
loid.  u/nae. 

2.  Lig.  faferale  externiim,  from  the  apex  of  the  Proc.  sly  hid.  radii,  broad 
to  the  outer  border  of  the  Os  navicultire  ;  strengthens  the  capsular  ligament. 

3.  Lig.  laterale  internum,  from  the  apex  of  the  Proc.  slyluid.  ulnx,  round- 
ish, with  one  portion  for  the  Os  jiisiforme,  the  other  for  the  os  friqnefru'n. 

The  synovial  capsule  is  loose  posteriorly.  Of  the  interarticular  cartilage 
or  lig.  triangulure,  vide  ante. 

Movements:  1.  Flexion. — The  three  carpal  bones  glide  from 
before,  backwards;  the  posterior  capsular  ligament  and  the  ten- 
dons of  the  extensor  muscles  are  stretched. 

2.  Extension. — The    three    carpal   bones  glide  from   behind 
forwards.     The  anterior  capsular  ligament  and  the  Ligg.  late- 
ralia  are  stretched,  and  prevent  loo  great  extension. 

3.  .Abduction. — The  radial  border  of  the  hand   is    directed 
towards   that  of  the   fore-arm ;   Proc.    Styloid.   et   extern,  oss. 
navicul.  prevents  farther  movement. 

4.  Adduction. — The  Ulna  border  of  the  hand  inclines  to  that 
of  the  fore-arrn  ;  Proc.  styloid.  u/nse  upon  os  triquelrum.    Luxa- 
tion is  difficult  and,  always,  only  incomplete. 

124.  VI.  Connection  of  the  Carpal  Bones,  Jlmphiar  thro  sis. 

The  articular  surfaces  of  the  carpal  bones  of  the  first  row  are 
oblique,  those  of  the  second  row  vertical. 

Ligaments  :  a.  Ligg.  inlertmea.  1.  Those  of  the  first  row  are  small  fibrous 
bundles  between  the  articular  surfaces ;  of  a  reddish  color.  2.  Of  the 
second  row,  thicker  and  closer,  on  the  entire  surface  of  the  bones. 

b.  Ligg.  wtluria,  thi  :ker  than 

c.  Li^g.  dorsalia. — Both  pass  transversely  or  obliquely  from  the  one  carpal 
bone  to  the  other. 

0*  puiifiirntc  is  united  by  l!g.  capsulare  and  two  ligg.  laleralia,  with  the  os 
cnnti for  me  by  the  lig.  inferius  externum  with  Proc.  unciform.  oss.  humati,  by 
lig.  inferius  internum  with  os  ntetacarpi  V. 

125.  VII.  Connection  of  the  two  rows  of  the  Carpal  Bones, 

Jirlicul.  carpo-carpalis. 

Os  capifafum  and  Os  hamatum  of  the  second  row  form  toge- 
ther an  articular  head,  which  sinks  into  an  articular  cavity  formed 
by 


110 


SPECIAL  ANATOMY. 


Os  naviculare,  lunatum  et  cuneiforme  of  the  first  row,  thus 
forming  a  Ginglymus  joint. 

Ligaments:  1.  Lig.  capsulare  commune,  passes  from  the  first  row,  os 
phi  forme  excepted,  to  the  second  row ;  is  more  dense  before  than  behind. 

2.  Lig.  volare  from  os  Cuneiforme  and  Naviculare  to  Os  capital,  or  Magnum 
and  Trapezium. 

3.  Lig.  dormle  from  the  first  row,  os  pisiforme  excepted,  to  the  whole  of 
the  second  row. 

4.  Lig.  laterale  externum  s.  radiale,  from  os  naviculare  to  os  trapezium. 

5.  .L?g.  laterale  internum  s.  ulnare,  from  os  cuneiforme  to  os  unciforme. 

A  single  synovial  capsule  lies  between  the  two  rows  of  carpal  bones,  with 
two  superior  and  three  inferior  small  blind  extensions  in  the  spaces  between 
the  separate  bones. 

\_Ligg.  Glenoid.  (Cruveilhier)  increase  the  depth  of  the  articular  cavities.] 

Movements.  The  separate  bones  move  scarcely,  or  not  at  all, 
upon  one  another ;  but  between  the  first  and  second  row  the 
following  movements  exist : — 

1.  Extension,  tolerably  limited,  as  the  strong  anterior  ligaments 
prevent  it. 

2.  Flexion,  and  indeed  to  such  an  extent,  that  the  os  magnum 
may  be  dislocated  backwards ;  flexion  of  the  hand  takes  place  in 
great  degree  through  this  articulation,  more  than  by  the  artic. 
carpo-radialis. 

126.  VIII.  Connection  of  the  Carpal  with  the  Metacarpal 
Bones,  Jlrlicul.  carpo-metacarpea. 

The  inferior  surfaces  of  the  second  to  the  fourth  carpal  bones 
of  the  second  row,  and  the  superior  of  the  second  to  the  fifth 
metacarpal  bones,  are  attached  angularly  to  one  another,  and  thus 
form  an  immoveable  articulation,  whilst  the  os  I.  metacarpi, 
thumb,  is  united  in  a  free  articulation,  moving  in  all  directions, 
with  the  os  trapezium. — Ligaments :  upon  the  dorsal  and  palmar 
surfaces  are  short  and  strong. 


1.  Os  metacarpi  II.  has  three  ligg. 
dorsalia;  a.  externum  to  os  trape- 
zium: b.  medium  to  os  irapezoid; 
c.  internum  to  os  magnum. 

2.  Os  metacarp.  III.  has  two  ligg. 
dorsalia :  a.  rectum  to  os  magnum  ; 
b.  obliquum  to  os  unciforme. 

3.  Os  metacarp.  IV.  has  one  lig.  dor- 
sale  to  os  trapezium /  longer  and 
looser  than  1.  and  2. 

4.  Os  metacarp.  I.,  thumb,  has  lig. 
capsulare,  a  loose,  large  ligament, 
which  passes  from  os  trapezium  to 


1.  Ligg.  volaria   2.  sublimi  et  pro- 
fundum  to  trapezium. 


2.  Ligg.  vol.  3.  exlernum  to  os  tra- 
pezium ;  medium  to  os  magnum  : 
internum  to  os  unciforme. 

3.  Lig.  vol.  1.,  to  os  unciforme. 


4.  Os  metacarpi  V.  has  lig.  capsulare, 
incomplete,  much  stronger  before 
than  behind,  where  the  tendon  of 


THE  LIGAMENTS. 


os  metacarp.  /.,  a  synovial  capsule 
to  itself,  behind,  assisted  by  m.  ex- 
tens,  poll.,  outside,  by  m.  abduct, 
long.,  inside,  m.  interos?ei  and  art. 
rad. ;  has  close  to  it  anteriorly  m. 
poUic.  minores. 


m.  extern,  ulna  protects  it,  and 
unites  with  os  unciforme.  Its.  sy- 
novial capsule  belongs  equally  to 
the  os  metacarp.  IV. 


NOTE.  Gunther  (d.  Handgelenk,  &c.)  enumerates  ninety  ligaments  in  the 
articulations  of  the  hand. 

Movements:  of  os  metacarpi  I.:  1.  Flexion,  obliquely  in- 
wards and  forwards,  approximates  the  thumb  to  thejiflh  os  meta- 
carpi (oppositio],  and  may  cause  luxation  backwards. 

2.  Extension,  goes  so  far,  that  upon  the  outer  side  almost  a 
right  angle  is  formed  between  os.  metacarp.  I.  and  the  radius  ; 
luxation  is  prevented  by  the  dense  posterior  portion  of  the  capsu- 
lar  ligament. 

3.  Abduction,  the  thumb  is  removed  directly  outwards  from 
os.  metacarp.  II. :  it  may  give  rise  to  luxation  inwards. 

4.  Adduction  is  limited  by  os  metacarp.  II. 

127.  -     IX.  The  heads  of  the  Metacarpal  Bones, 

of  the  second  to  the  fifth  are  united  together  by  Kg.  transversum, 
(volare,)  which  passes  from  one  to  another  like  a  bridge,  lying 
below  the  tendinous  sheaths  of  the  m.  flexor  digit.,  and  serving 
for  the  attachment  of  the  m.  lumbricales.  The  central  portions 
of  the  ossa  metacarp.  are  maintained  in  their  situation  by  Kgg. 
interossea. 

128.  X.  Connections  of  the  Fingers. 

A.  With  the  metacarpal  bones. — Free,  ball  and  socket  articu- 
lation ;  that  of  the  thumb,  Ginglymus.  Articular  surfaces :  on 
the  metacarpus — even,  like  a  head,  oval  from  behind,  forwards. 
On  the  first  phalanx — smooth  fossa,  oval  transversely. 

Ligaments:  1.  Lig.  anterius  s.  transversum,  very  strong  and  dense  on  the 
palmar  surfaces  of  the  second  to  the  fifth  fingers,  filling  up  the  articular  cavity; 
connected  with  the  tendinous  sheaths  of  the  mm.  flexores,  above  very  loose  on 
the  Collum  capituli  oss.  metacarpi. 

2.  Ligg.  lateralia,  very  strong,  passing  obliquely  from  behind  forwards,  and 
from  above  downwards,  from  tubercul.  oss.  metacarpi  to  the  Kg.  anterius  of  either 
side.  On  the  dorsal  surface  the  tendinous  sheath  of  the  m.  extensor,  takes  the 
place  of  ligament.  [There  is,  however,  a  thin  delicate  capsule.]  In  the  lig. 
anterius  oss.  metacarp.  I.  are  placed  two  ossa  sesamoidea. 

Movements:  1.  Flexion  the  most  marked,  especially  in  the 
first,  fourth,  and  fifth  joint.  The  finger  can  describe  a  right  angle 
with  the  centre  of  the  hand.  Flexion  is  limited  by  the  posterior 
fibres  of  the  lig.  lateralia. 


112  SPECIAL  ANATOMY. 

2.  Extension,  to  the  extent  of  an  obtuse  angle,  is  restrained  by 
the  ring  which  Lig.  anterius  and   the  anterior  fibres  of  Ligg. 
later  alia  form.     In  too  violent  extension  the  Capitul.  os.  meta- 
carp.  passes  over  the  ring  or  tears  it,  and  dislocation  of  the  finger 
backwards  arises,  which  can  only  be  reduced,  if  the  ring  is  actu- 
ally lacerated,  but  is  prevented  if  it  is  pushed  between  the  articu- 
lar surfaces. 

3.  Abduction  and  Adduction. 

B.  The  phalanges  with  each  other — Ginglymus.  Articular 
surfaces  :  a.  At  the  inferior  extremity  of  the  I.  phalanx — a  troch- 
lea  with  two  small  condyles.  b.  At  the  superior  extremity  of 
phalanx  I.  and  II., — two  small  fossae. 

Ligaments:  1.  Ligg.  capsularia,  on  the  dorsal  surface  loose  and  thin,  and 
formed  even  here  of  the  fibres  of  the  tendinous  sheaths  of  mm.  extensor.,  the 
rest  like  the  Kg.  ant.,  as  in  A. 

2.  Ligg.  laleralia  ext.  et.  int.,  as  in  A. 

3.  Capsulce  synoviales,  in  A  and  B  are,  especially  on  the  dorsal   surface, 
very  loose,  not  connected  with  the  tendons,  stretch  in  flexion,  and  fold  up  in 
extension. 

Movements:  Flexion.  That  of  the  second  phalanx  is  more 
marked  than  that  of  the  third. 

Extension  is  much  more  restrained  than  in  the  metacarpo-pha- 
langeal  articulation.  Lateral  motion  is  not  possible. 

129.         Connections  of  the  Inferior  Extremities. 

1.  Of  the  Thigh  with  the  Pelvis,  Jlrticulalio  coxx,  hip-joint. 

Articular  surfaces :  Head  of  the  femur  and  acetabulum,  united 
in  a  ball  and  socket  joint,  not  admitting  air,  less  moveable,  but 
stronger  than  the  shoulder  joint. 

Ligaments:  1.  Labrum  cartilagineum  acetabuli,  a  fibrous  ring,  of  four  lines 
thick,  encircling  the  edge  of  the  acetabulum,  which  it  deepens,  passes  over 
the  incisura  ace'abuli  below  and  before,  as  lig.  transfers,  acelabuli,  and  thus  forms 
theforam.  acelabuli,  for  the  vessels  of  the  joint;  is  thicker  above  and  behind; 
narrower  at  its  free  than  at  its  attached  border.  Consists  entirely  of  fibrous 
tissue.  See  Inter  articular  Cartilage. 

2.  Ligam.  capsulare  femorls,  passes  from  the  border  of  the  bony  acetabulum 
in  front,  to  the   linea  intertrochanter.  anter. ;  behind,  as  far  downwards  as  the 
centre  of  the  neck  of  the  femur;  is  of  a  dull  white  hue,  composed  of  crossed 
fibres,  two  lines  thick,  strong,  solid,  and  looser  at  the  sides;  above  and  exter- 
nally, beneath  the  tendon  of  the  m.  recius  femoris,  thicker;  is  strengthened  by  a 
bundle  of  fibres,  the  Z.f>na  orbicularis  seu  lig.  anterius  suj>erius,  which  passes 
obli  jueiy  from  Spina  ilei  anler.  infer,  to  the  inner  part  of  the  basis  colli  jemoris, 
around  this  anteriorly  and  back  to  the  Spina.     Anteriorly,  the  fibres  of  the  m. 
Psoas  and   lliacus,  and  tlu-ir  synovial  sheaths  are  attached  to  it.      Internally 
are  situate:!  the  m.  obturator  extern,  el  pedinaus;  externally  glut  tens  nri/iimus  ; 
behind  quadratus  femor.  •  bigemini,  pyramidalis  obturator  inter nus. 


THE  LIGAMENTS.  H3 

3.  Lig.  tercs  femoris,  one  inch  long,  passes  ftom  the  fovea  pro.  tig.  terete  upon 
the  head  of  the  femur,  becoming  broader  in  its  course  and  dividing  to  be 
attached  to  the  fovea  acetabuli.  It  lies  between  the  two  articular  surfaces,  is 
sometimes  very  thin  and  even  wanting. 

The  synovial  capsule  lies  inside  the  lig.  capsidare,  lines  it,  the  neck  of  the 
femur,  the  articular  surfaces,  the  lig.  teres,  and  is  generally  in  connection  on 
the  inner  side  of  the  Zona  orbic.,  perforating  the  capsular  ligament,  with  the 
bursa  iKaca,  which  is  the  bursal  sac  of  the  flexor  femoris. 

Movements :  1 .  Flexion,  the  thigh  brought  forwards :  the  head 
of  the  femur  rolls  from  before  backwards  in  the  acetabulura.  In 
consequence  of  the  oblique  position  of  the  neck  of  the  femur,  it 
is  possible  for  the  knee  to  touch  the  shoulder. 

2.  Extension :  this  backward  movement  is  limited  by  the  pos- 
terior portion  of  the  neck  of  the  femur  striking  against  the  edge 
of  the  acetabulum,  and  the  head  is  supported  in  its  movement 
forwards  by  the  Zona  orbicularis  and  m.  psoas  et  iliacus. 

3.  Abduction,  the  limb  directed  outwards.     The  head  presses 
against  the  internal  relaxed  portion  of  the  Lig.  capsttl.;  and  this, 
the  lig.  teres,  and  the  meeting  of  the  upper  part  of  the  neck  of 
the  femur,  and  the  edge  of  the  acetabulum,  prevents  its  escape. 

4.  Adduction:  one  thigh  approaches  the  other,  and  may  cross 
it  with  the  assistance  of  slight  flexion.     The  depth  of  the  ace- 
tabulum  and  the  strength  of  the  capsular  ligament  above  and 
externally  prevent  the  escape  of  the  head  upon  this  side.     The 
Lig.  teres  stretches ;  it  is  torn  in  the  dislocation  of  the  thigh,  so 
frequent  in  this  situation,  from  a  fall  upon  the  knee,  &c. 

5.  Rotation:    The  internal  portion   of  the  head  of  the  thigh 
moves  horizontally  forwards,  the  anterior  of  the  shaft  outwards; 
and  the  reverse.     Rotation  is  impossible  in  fracture  of  the  neck 
of  the  femur. 

130.  II.  Of  the  Thigh  with  the  Leg  Bone,  ArticuLatio  genu, 
Knee-joint. 

Ginglymus.  Articular  surfaces :  1.  On  the  femur,  two  roller- 
like  condyles,  between  which  is  a  deep  fossa;  2.  On  the  tibia, — 
in  the  centre  the  eminentia  media,  on  the  sides  fossae,  for  the 
condyles ;  3.  Patella, — in  the  centre  a  vertical  elevation,  which 
lies  anteriorly  in  the  Incissura  inter-condyloidea  oss.femor.  All 
the  articular  surfaces  are  smooth  and  covered  with  cartilage.  In 
addition : 

Cartilagines  semilunares,  two  sickle-shaped  cartilages,  "which  lie  between 
the  Condyl.  oss.  femoris  et  tibia,  and  are  connected  together  by  a  delicate  Kg. 
transvers.  Their  external  border  is  thick,  the  internal  sharp,  tlie  anterior  and 
posterior  cornua  thin;  by  these  the  fossae,  close  to  the  eminentia  tibiae,  are 
deepened.  The  external,  smaller,  almost  crescentic  cartilage,  nearly  covers 
the  entire  fossa*  Its  cornua  are  attached  between  the  two  tubercles  of  the 

8 


]jl4  SPECIAL  ANATOMY. 

trpimntia  media.  Posteriorly  a  thick  fibrous  band  passes  from  it  around  the 
lig.  cruciat.  postic.,  and  is  attached  behind  this  to  the  condyl  extern,  femoris. 
The  internal  cartilage  is  larger,  does  not  so  much  cover  the  fossa;  attaches 
itself  by  the  cornua  before  and  behind  the  projections  of  the  eminent,  media; 
the  posterior  cornu  is  covered  by  the  lig.  cruciat.  postic. 

,  Ligaments:  1.  Lig.  capsulare  genu,  large  and  loose,  weakest  in  front  and  at 
the  sides,  behind  united  with  lig.  poplitawm  ;  passes  off  from  the  superior  bor- 
ders of  the  Condyli  femar.  to  the  circumference  of  the  articular  surfaces  of  the 
Xibia  and  the  posterior  of  the  Patella,  behind  lig.  Patella. 

2.  Lig.  poplitcEum  [the  posterior  ligament  of  Winslow],  oblique  from  Condyl. 
extern,  femoris  to  the  internal  border  of  the  Condyl.  internus  tibia;  strong,  flat. 

3.  Lig.  Patella,  a  portion  of  tendo  comm.  extensorius,  thick,  almost  triangular, 
broad  at  the  apex  of  the  Patella,  narrower  at  the  inferior  part,  the  tuberosit. 
tibia. 

4.  Ligg.  lateralia  genu.     a.  externum,  round,  tendon  like,  lies  before  and  be- 
tween the  two  heads  of  the  m.  biceps  fern. ;  from  condyl.  extern,  fem.  to  the 
outer  portion  of  the  capitul.  fibula ;  extern,  breve  lies  behind  a,  and  is  attached 
higher  up  to  capit.fib.     b.  internum,  broad  and  thin,  from  the  posterior  portion 
of  condyl.  intern,  femor.  to  the  condyl.  intern,  tibia,  is  below  covered  by  the  ten- 
dons of  thePes  anserinus  (see  Myology),and  connected  with  the  Cartil.  semilunar. 
intern.     Both  lie  rather  posteriorly  behind  the  centre  of  motion  of  the  joint,  are 
slackened  in  flexion  and  limit  extension. 

5.  Ligg.  cruciata  s.  interossea,  crossed  like  the  capital  letter  X  between  the 
articular  surfaces  of  oss.  femor.  et  tibia,  in  the  Incisura  intercondyloidea. 

a.  Lig.  cruciat.  anticum.  passes  from  the  posterior  internal  surface  of  the 
Condyl.  extern,  to  the  most  anterior  portion  of  the  eminentia  media  tibia;  be- 
hind it  the  longer  and  thicker  (b),  lig.  cruciat.  posticum;  from  the  anterior  inner 
surface  of  Condyl.  intern,  to  the  posterior  extremity  of  the  eminentia  media.  It 
is  connected  with  the  Cartil.  semilun.  externa;  it  slackens  under  extension, 
and  stretches  in  flexion  of  the  joint,  whilst  the  Lig.  antic,  is  slackened  in 
flexion. 

A  synovial  capsule  is  very  distinct;  a  shut  sac  lies  above  between  tendo 
extensor  et  femur;  at  the  sides  of  the  patella,  on  the  inner  side  especially, 
beneath  the  m.  vastus  internus,  the  ligg.  alaria  which  blend  behind  with  a 
fibrous  fold,  Lig.  mucosum  s.  adiposum.  It  invests  the  whole  internal  surface 
of  the  capsular  ligament,  the  two  surfaces  of  the  Cartilagg.  semilunares,  and 
envelopes  the  lig.  cruciata.  Between  it  and  the  lig.  patella  much  fat  is  found, 
as  well  as  about  the  ligg.  cruciata,  and  chiefly  in  the  incis.  intercondyl. 

Movements:  1.  Flexion.  The  heel  may  touch  the  thigh. 
The  posterior,  lateral,  and  posterior  crucial  ligaments  are  relaxed, 
the  ligament  of  the  patella  is  stretched,  and  the  bone  is  fixed,  in 
front  of  the  space  between  the  femur  and  tibia. 

2.  Extension.     The   articular  surfaces  of  the  tibia  with  the 
cartiL  semilunar.  roll  from  behind  forwards,  until  the  thigh  and 
leg  lie  in  the  same  line.     Lig.  patellse  and  cruciat.  anticum  are 
relaxed,  the  rest  become  stretched.     The  Patella   may  be  dis- 
placed. 

3.  Rotation,  inwards  and  outwards,  is  very  limited,  and  is  only 
performed  by  the  condylus  internus.     It  is  effected,  outwards, 
by  the  action  of  the  m.  biceps  fem. ;  inwards,  by  the  m.  pop- 
htmu. 


THE  LIGAMENTS.  115 

131.  Connection  of  the  Tibia  and  Fibula. 

A.  Superior,  Articul.   tibio-fibularis    superior  —  is   immove- 
able.     The  articular  surface  of  the  tibia,  at  the  posterior  part  of 
the  Condyl.  extern,  tibise,  looks  downwards  and  outwards;  that 
of  the  Jwttla  at  the  internal  part  of  the  superior  extremity,  up- 
wards and  inwards. 

Ligaments:  1.  Lig.  capsulare  capit.  fibula,  passes  obliquely  outwards  and 
downwards  from  the  border  of  the  articular  surface  of  the  Condyl.  extern,  lib. 
to  the  Capit ul.  fibula ;  it  is  short  and  strong. 

B.  Inferior,  Articul.  tibio-fibular.  inferior — likewise  immove- 
able.     The  articular  surfaces  are  only  in  part  grasped  by  one 
another,  and  in  other  parts  a  strong  interosseous  ligament  fills  the 
space  between  them.     The  synovial  capsule  belongs  partly  to  the 
tarsal  joint. 

Malleolar  ligaments:  1.  Lig.  tibio-fibul.  anticum,  between  the  anterior 
tubercle  of  the  Incis.  peroncea  tibia,  and  that  of  the  Matteolus  extern,  (fibula). 

2.  Lig.  tibio-fibul.  post.,  between  the  posterior  tubercles  of  the  same  parts. 

Both  divide  into  a  superior  and  inferior  fasciculus,  pass  obliquely  from 
above  to  below,  and  from  within  to  without,  and  project  beyond  the  articular 
surfaces. 

C.  Central,  Membrana  interossea  cruris,  stretched  in  the  inter- 
space between  the  tibia  and  fibula,  it  separates  the  anterior  from 
the  posterior  muscles  of  the  leg;  above  it  is  broader  than  below; 
externally  and  above,  it  has  an  opening  for  the  Vasa  tibial.  an- 
tica;  below,  it  is  perforated  by  the  Vasa  peronxalia.     Its  fibres 
are  directed  obliquely  from  within,  outwards   and  downwards. 
Anteriorly  are  attached  to  it :  mm.  extensores  hallucis  et  digitor 
commun.  longus;  behind,  m.  tibialis  posticus,  flex,  digit,  com- 
mun.  longus. 

132.      Connection  of  the  Foot  with  the  Leg,  Artie,  pedis 
s.  tibio-tarsalis. 

The  ankle  joint  is  a  ginglymus ;  that  is  to  say,  it  consists  of  a 
roller  which  moves  forwards  and  backwards  in  a  depression  on 
the  tibia. 

Articular  surfaces:  1.  On  the  leg  (tibia  and  fibula),  a  fossa 
divided  into  two  halves  by  a  projection,  bounded  laterally  by  the 
malleoli.  2.  On  the  foot  (talus),  a  roller,  with  lateral  articular 
surfaces,  for  the  malleoli. 

Ligaments:  a.  Ligg.  lateralia  externa  s.  fibularia,  three,  passing  from  the 
fibula  either  to  the  Talus  or  Calcaneus. 

1.  Fibulare  calcanei  s.  perpendiculare  medium,  roundish,  under  the  sheaths  of 
the  peronaei  muscles,  passes  from  the  apex  of  the  Malleolus  extern,  to  the  outer 
side  of  the  os  calds. 


116  SPECIAL  ANATOMY. 

2.  Fibulare  astragali  anticum,  very  short,  from  the  anterior  border  of  the 
Mall,  extern,  to  the  Astragalus,  below  broader. 

3.  Fibulare  astragali  posticum,  close  upon  the  capsule,  almost  horizontal, 
from  the  fossa  within  and  behind  on  the  malleolus  to  the  posterior  border  of 
the  Talus  or  Astragalus. 

b.  Lig.  laterale  internum  s.  tibiale,  stronger  than  the  anterior,  consisting  of 
two  layers; 

1.  Superficiale  s.  deltoideum,  from  the  apex  and  the  anterior  and  posterior 
border  of  the  malleolus  intern,  to  the  calcaneus  and  lig.  calcaneo-naviculare  ;  the 
most  anterior  fibres,  that  is,  lig.  later,  iniern.  anterius,  a  thin  layer,  passes 
directly  forwards  to  the  collum  astragal,  and  os  navicul. 

2.  Profundum,  below  this,  stronger,  outwards  and  downwards ;  from  the 
apex  and  the  borders  of  the  malleolus  to  the  internal  part  of  the  Talus,  below 
the  articular  surface. 

The  Synovial  capsule  is  very  loose  anteriorly,  and  covered  with  fat. 

Movements:  1.  Flexion.  The  Talus  glides  from  before, back- 
wards; the  Collum  tali  meets  the  anterior  border  of  the  articular 
fossa,  so  that  dislocation  is  scarcely  possible.  The  dorsum  of  the 
foot  moves  upwards  and  backwards. 

2.  Extension:  Talus  glides  from  behind,  forwards.  Displace- 
ment is  rare.  The  dorsum  of  the  foot  moves  downwards  and  for- 
wards. Lateral  motion  does  not  take  place  in  this,  but  in  the 
tarsal  joints. 

133.  Connection  of  the  Tarsus,  Artie.,  tarsi. 

1.  The  first  row,  that  is.  Talus  and  Calcaneus,  are  united  in  a 
limited  Artkrodia,  by  which  the  lateral  movements  of  the  foot  are 
performed. 

Articular  surfaces :  On  the  inferior  surfaces  of  the  Talus  an 
anterior  convex  and  a  posterior  concave.  On  the  superior  surface 
of  the  calcaneus,  a  posterior  convex  and  an  anterior  concave. 

Ligaments:  1.  Lig.  inteross.  (s.  Jlpparat.  ligamentosus  sinus  tarsi),  strong. 

2.  Lig.  capsulare  astragalo-calcaneum  (Synovial  capsule),  thin;  internally 
8trengthened  by  the  fibrous  sheaths  for  the  tendons  of  the  M.  tibialis  post.,  flex, 
digitor.  comm.,  and  propr.  hallucis;  anteriorly  and  posteriorly,  by  small  bundles 
of  fibres. 

134.  II.  The  second  row,  namely, 

Ossa  cumiformia,  three  in  number,  naviculare  and  cuboideum, 
are  united  in  close  articulations,  umphiarthroses,  with  one  another. 

a.  Os  naviculare  unites  anteriorly  with  the  three  cuneiform 
bones  by  an  articular  surface  divided  into  three  facettes,  each  of 
which  is  triangular.  The  ligaments  are: 

1.  Lig.  dorsalia,  two  for  the  Os  cuneifor-me  /.,  straight  from  before  to  behind; 
one  for  each  of  the  two  others,  passing  obliquely  forwards  and  outwar  Js. 


THE  LIGAMENTS.  117 

2.  Ligg.  plantaria.  Those  of  the  second  and  third  cuneiform  bones  are 
indistinct ;  on  the  contrary,  that  of  the  first  very  strong,  from  tuberc.  oss.  navicul. 
to  that  of  the  cuneiforme  I. ;  losing  itself  in  the  tendon  of  the  m.  tibialis  anticus, 
which  is  extended  to  the  Os  cuneiforme  HI.  and  Os  metatars.  III.,  and  forms 
hg.  tarsi  inferius. 

b.  Ossa  cuneiformia  are  united  together  by  very  firm  trans- 
verse 

1.  Ligg.  dorsalia ;  connected  above  with  the  mm.  extensores  digitar.;  below, 
with  the  periosteum. 

2.  Ligg.  interossea,  very  strong,  and  firmly  attached. 

c.  Os  cuneiforme  III.  and  os  cuboideum  are  united  by  very 
strong  transverse 

1.  Lig.  dor  sale. 

2.  Lig.  interossewn,  around  the  articular  surface. 

3.  Lig.  plantare,  thin. 

d.  Os  naviculare  and  os  cuboideum  united  by 

1.  Ar  oblique  Lig.  dorsale. 

2.  Lig.  interosseum. 

3.  Lig.  plantare,  very  thick,  transverse  from  tuber,  oss.  navicul.  to  the  o* 
cuboideum. 

135.  III.  Connection  of  the  first  with  the  second  row. 

a.  Talus  and   os  naviculare.     The  fossa  of  the    navicular 
bone,  in  which  the  head  of  the  talus  is  received,  is  deepened  by 

1.  Lig.  calcaneo-naviculare  inferius  (plantare);  it  forms  the  internal  portion, 
and  lies  in  the  triangular  space  between proc.  minor,  calcan. and  os  naviculare; 
consists  sometimes  of  an  internal  and  external  portion,  the  last  round  and 
cartilaginous;  is  sometimes  represented  by  a  thin,  osseous   plate  from  the 
calcis,  so  that  the  Calcaneus  and  os  naviculare  come  into  immediate  contact. 

2.  Lig.  Calcaneo-naviculare  superius  (dorsale),  from  the  internal  side  of  the 
anterior  extremity  of  the  Calcaneus  to  the  external  of  the  os  naviculare  ;  in  the 
deep  hollow  on  the  outside  of  the  Talus,  which  is  filled  with  fat. 

The  talus  is  also  firmly  united  with  the  os  naviculare,  by 
means  of  the  calcaneus  only,  but  it  may,  by  strong  concussion, 
escape  from  its  connection.  Its  own  ligament  is  weak,  namely  : 

3.  Lig.  astragalo-naviculare  superius,  from  Collum  tali  to  the  circumference  of 
the  articular  surface  of  Os  naviculare;  above,  covered  by  m.  extens.  digitor. 
brevis;  semicircular. 

b.  Calcaneus  and  os  cuboideum,  the  articular  surfaces  recipro- 
cally coincide.     Tubercle  on  the  Calcaneus,  important  in  Ampu- 
tation. 

Ligaments:  1.  Lig.  calcaneo-cuboideum  plantare,  the  strongest  of  the  tarsal 
ligaments;  passing  from  the  entire  inferior  surface  of  the  Calcan.  to  the  po»- 
terior  of  the  Os  cuboid.,  it  may  be  divided  into  a  superficial  and  deep. 

2.  Lig.  calc.-cub.  internum,  short,  narrow,  strong,  in  the  fossa  between  tahu 


118  SPECIAL  ANATOMY. 

and  calcaneus,  describing  with  the  lig.  calcan.  navicul.  mperius  a  figure  like  the 
capital  letter  Y ;  after  their  division,  the  two  rows  of  tarsal  bones  separate 
from  each  other. 

3.  Lig.  calc.-cub.  superius,  thin,  small,  from  Calcaneus  to  os  cuboideum. 

Movements:  Adduction  and  Abduction, 'whereby  the  sole  of 

the   foot  is  turned  inwards  or   outwards,  arising  by  talus  and 

calcaneus  on  one,  os  naviculare  and  cuboideum  on  the  other 

.side,   assisted  by   slight   lateral   movement   between    talus    and 

calcaneus. 

136.  Connection  of  the  Metatarsal  Bones, 

Artie,  metatarsi. 

These  bones  are  united  with  those  of  the  tarsus  and  with  one 
another  by  close  articulations. 

137.  A.  With   the  tarsus.     1.  The  tarsal  extremity  angular, 
with  even  articular  surfaces.     That  of  the  third  metatarsal  bone 
makes  an  angle,  forwards,  with  the  line  of  the  rest. 

a.  Os  metatarsi  I.  1.  Lig.  plantare,  stronger  than  the  Lig.  dorsak,  with 
synovial  capsule.  2.  Aponeurosis  of  the  tendon  of  m.  peronaus  long,  to  the 
os  cuneiforme  L  3.  Aponeurosis  of  the  tendon  of  m.  tibialis  anticus  to  the  Os 
metatarsi  L 

•  b.  Os  metatars.  II.  1.  Lig.  plantaria,  two  from  the  second  cuneiform,  the 
third  from  first  cuneiform  bone,  lateral.  2.  Lig.  dorsalia,  three;  a.  internum 
from  first  cuneiform ;  0.  externum  from  third  cuneiform,  thin ;  y.  medium  from 
.second  cuneiform. 

c.  Os  metatars.  III.     1 .  Lig.  dorsak  from  third  cuneiform.    2.  Lig.  plantare, 
very  thin ;  instead,  the  tendon  of  m.  peronteus  long.     3.  Lig.  laterak  extern,  seu 
interosseum. 

d.  and  e.     Oss.   metatars.  IV.  and   V.     1.  Lig.  interossea,  very  strong.     2. 
Lig.  dorsak  and  lig.  obliquum,  on  oss.  metatars.  V.,  very  loose.     Instead  of  Lig. 
plantare,  the  tendon  of  the  muscles  peron.  long,  and  tibial.  posticus. 

138.  B.  The  posterior  extremities  with  each   other. »  Ligg. 
baseos  ossium  metatarsi. 

1.  Ligg.  dorsalia.  2.  plantaria,  stronger.  Transverse  from  the  one  to  the 
other  bone. 

3.  Ligg.  interossea,  strong,  short,  and  thick,  between  the  rough,  lateral  sur- 
faces, are  wanting  between  the  first  and  second  os  metatars. 

139.  C.  The  anterior  extremities.     No  articular  surfaces,  but 
synovial  capsules ;  rather  moveable  on  one  another.         „ 

1.  Lig.  transversum  s.  capitulorum  oss.  metatarsi,  on  the  sole  between  the 
heads,  below  the  sheaths  of  the  tendons  of  the  flexor  muscles ;  loose. 

Movement:  indistinct. — Os  Metatars.  I.,  of  great  toe,  is  not 
more  moveable  than  the  rest. 


THE  LIGAMENTS.  H9 

140.    Connection  of  the  toes,  Artie,  digitorum  pedis. 

a.  Of  the  metatarsal  bones  with  the  toes,  by  ball  articulation ; 
b.  Of  the  phalanges  with  each  other,  by  Ginglymus.  On  the 
first  phalanx  of  the  great  toe  a  double  pulley  with  ossa  sesa- 
moidea. 

1.  Lig.  capsularia,  very  thick,  cartilaginous  in  the  sole,  where  is  a  groove 
for  mm.  flexares,  very  thin  on  dorsum,  strengthened  by  tendons  of  extensor 
muscles,  beneath  which  is  a  loose  synovial  capsule. 

2.  Ligg.  later  alia,  very  strong,  from  the  capsular  ligaments  obliquely  to  the 
tubercula  behind  the  head  of  the  oss.  metatarsi,  and  ossa  sesamaidea,  and  the 
Phalanges. 

Movements :  Flexion  limited  by  the  lateral  ligaments  and  ex- 
tensor tendons.  Extension  restrained  by  the  inferior  portion  of 
the  capsular  ligament.  Both  these  more  marked  than  abduction 
and  adduction  which,  moreover,  only  occur  between  the  meta- 
tarsal bones  and  first  phalanges.  The  great  toe  is  far  less  move- 
able  than  the  thumb. 


OF  THE  MUSCLES. 

MYOLOGIA. 


"  The  application  of  muscles  in  an  animal  body  is  either  to  produce  a 
quantity  of  motion  equal  to  the  quantity  of  contraction  of  the  muscle ;  or,  by 
the  application  of  levers,  to  give  a  greater  motion  than  could  be  produced  by 
the  single  contraction  of  the  muscle.  This,  in  general,  is  not  the  case  in  ma- 
chines composed  by  art;  for  in  art  the  principal  reason  for  the  introduction  of 
mechanics  is  to  acquire  power  in  the  effect,  which  obliges  us  to  increase  the 
velocity  in  the  moving  cause,  as  in  levers  and  pulleys." 

HUNTEK.    Croonian  Lectures,  No.  IIL 


MUSCLES. 

LITERATURE. 

Minute  Structure: — 
Ant.  v.  Leeuvenhoeck.     Some  Microscopical    Observations   upon   Muscles,  &c. 

Philos.  Trans.,  vol.  xxvii.,  1712;  and  in  vol.  xi.,  1677;  vol.  xxix.,  1714; 

vol.  xxxi.,  1720;  vol.  xxxii.,  1722. 
F .  Fontana.     Traite  sur  le  Venin  de  la  Vipere.     A  translation  into  English, 

2  vols.,  under  the  title  "  Fontana  on  the  Venom  of  the  Viper,"  &c.     2 

vols.  1787. 
Bowman.     Philos.  Trans.,  1840-41,  and  his  article  in  Cyclopaedia  of  Anat. 

At  the  end  of  which  is  a  long  list  of  works. 
Carpenter.     Manual  of  Physiology.     1846. 
Goodfellow.     Some  Remarks  on  the  Internal  Structure  of  Voluntary  Muscle. 

London  Phys.  Journal,  1844. 

Hunter,  John.     Croonian  Lectures ;  Palmer's  edit,  of  his  Works,  vol.  iv. 
Homer,  W.  E.     Lessons   in   Prac.  Anat.     Philadelphia,   1827;    for    Tensor 

Tarsi  Muscle,  and  "Description  of  a  small  Muscle  at  the  intern.  Com- 
missure of  the  Eyelids."     Phil.,  1824. 
Jllbinus.     Tab.  Muse.  Corp.  Humani,  fol.  1749. 
Gimbernat.     On  Femoral  Hernia.     Trans.     1795. 
King,  T.  W.    Anal  Muscles.    Guy's  Hosp.  Reports,  1843. 


123 


141.  MUSCLES,  MUSCULI, 

form  the  soft  fibrous  organs,  the  substance  of  which  is  known  by 
the  name  of  flesh,  and  which,  by  the  capacity  they  enjoy  of  con- 
tracting, produce,  in  an  especial  manner,  the  movement  which  is 
permitted  by  the  articular  connection  of  the  bones  and  the  mo- 
bility of  the  soft  parts.  They  consist,  independently  of  fibro- 
cellular  tissue,  vessels  and  nerves  which  enter  into  their  formation, 
of  a  peculiar  tissue  which  is  closely  related  to  that  of  the  con- 
tractile coat  of  vessels. 

142.  a.  Tissue  of  muscles. 

Every  muscle  is  composed  of  a  number  of  bundles  of  fibres,  each  of  which 
again  consists  of  filaments  which  are  even  once  more  divisible ;  so  that  we 
may  distinguish  primary,  secondary,  and  tertiary  divisions.  All  are  united 
together  by  a  general  fibrous  envelope,  perimysium,  as  well  as  each  being  sur- 
rounded by  its  own  particular  investment,  which  connects  it  with  the  sheath. 
The  tertiary  bundles  are  three-sided,  prismatic,  about  2'"  broad,  and  consist  of 
the  flat  secondary  divisions,  lying  longitudinally  to  one  another,  |  to  %"  broad, 
which  on  their  side  are  formed  of  the  red  or  pale,  flat,  fine  primary  divisions, 
0-005'"  in  diameter. 

In  the  primary  bundles  we  observe  under  the  microscope  many,  10  to  500, 
longitudinal  striae,  which  also  display  many  delicate  filaments,  fibrilla?,  primi- 
tive filaments,  lying  parallel  to  one  another,  appearing  of  a  yellowish  red,  and 
perforated  by  transverse  striae,  or  even  only  little  points,  whereby  an  angular, 
articulated  appearance  is  produced.  Whether  a  canal  exists  in  the  axis  of 
the  primary  bundle,  filled  with  a  gelatinous  substance,  as  in  the  Embryo,  ac- 
cording to  Valentin,  is  still  doubtful.  The  longitudinal  stria?,  even  the  primi- 
tive filaments  also,  and  transverse  striae,  are  not  found  in  all  muscles. 

Hence  we  distinguish,  transversely  striped,  striated  [compound]  (varicose, 
articulated),  and  unstriped  [simple]  organic  muscular  fibres. 

1.  To  the  striated  belong  all  the  so-called  animal,  or  muscles  of  voluntary 
movement,  and  of  the  heart. 

2.  To  the  unstriped  all  the  so-called  organic,  or  muscles  of  involuntary 
movement,  with  exception  of  the  heart. 

143.  b.  Characteristics  of  muscular  tissue. 

1.  Chemical.     It  is  little  changed  by  water  and  spirits  of  wine ;  very  easily 
decomposes,  and  at  last  breaks  up  by  means  of  Gastric  juice  into  globules,  but 
yields  on  boiling  only  very  little  gelatin  (from  the  sheaths).     Primitive  fibres 
and  sheaths  are  soluble  in  concentrated,  are  rendered  transparent  and  soft  by 
dilute  acetic  acid ;  by  Potass,  carb.  firm,  in  consequence  of  which  the  wave- 
like  and  cylindrical  form  of  the  fibres  shows  very  distinctly. 

Chemical  constituents:  much  water  (0-77),  Albumen,  and  Hs-matin,  Al- 
coholic and  watery  extract,  with  some  phosphorus,  soda,  and  lime,  and  lactic 
acid ;  lastly,  fibrin,  fat,  and  gelatin. 

2.  Physical  Characters.     The  red  colour  of  the  muscles  is  not  dependent 


124  SPECIAL  ANATOMY. 

upon  the  capillary  vessels  ramifying  throughout,  but  upon  a  peculiarity  in  the 
colouring  matter  united  with  them.  The  fibres  are  soft,  but  firm,  and  during 
life  with  difficulty  torn ;  their  elasticity  is  trifling.  After  death  they  become 
stiff  (from  seven  to  ten  minutes),  as  the  fibrin  coagulates,  which  is  the  rigid- 
ity of  death,  rigor  mortis. 

3.  Physiological  Characters.  Muscles  are  endowed  with  the  faculty  of 
contracting  in  the  direction  of  their  fibres.  In  consequence,  those  parts  be- 
tween which  they  are  attached  approach  more  closely  together.  The  con- 
traction, by  means  of  which  the  fibres  shorten,  become  closer  and  harder,  oc- 
curs in  consequence  of  the  sudden  bending  together  of  the  fibres,  from  the 
extremities  towards  the  centre,  or  curling  up  in  a  zigzag  form,  in  the  trans- 
verse striae  (crispalio),  and  is  the  result  of  an  influence,  which  the  will,  the 
blood,  and  certain  external  irritations,  exercise  upon  the  numerous  interlaced 
(motor)  nerve  fibres  in  the  muscles.  The  irritability  (irritabilitas  Hatteri)  of 
the  muscles  (produced  by  galvanism,  cold,  &c.)  is  only  extinct  some  time  after 
death.  Also,  the  slight  shortening  maintained  during  life  (tension,  tonus)  ter 
minates  immediately  with  death,  or  by  palsy  of  the  nerves.  Whilst  at  rest 
the  muscles  possess  their  greatest  power  (Schwann).  During  every  con- 
tinued movement  a  small  quantity  of  Plasma  is  effused  which,  becoming  meta- 
morphosed into  the  substance  of  the  muscle,  accounts  for  their  increase  of 
size.  Muscles  act  (generally)  as  the  power  in  levers  of  the  third  order,  that 
is  to  a  disadvantage,  since  the  power  is  broken  between  the  fulcrum  and  the 
weight. 

144.  c.  Vessels  and  nerves  of  muscles. 

Arteries.  They  generally  enter  on  the  inner  side  of  the  middle  part  of  the 
muscle,  dividing  between  the  larger  bundles  into  large  branches,  from  which 
smaller  pass  off  between  the  smaller  bundles,  until  they  finally  go  into  a  long 
capillary  network  which  encompasses  the  primitive  fibres,  and  discharges  into 
the  veins  which  follow  the  course  of  the  arteries. 

Nerves  correspond  in  number  and  size  (not  always)  to  that  of  the  muscles. 
The  nerves  of  motion  principally  prevail  over  those  of  sensation,  in  muscles, 
with  which  their  trifling  degree  of  sensation  corresponds.  They  generally 
enter  the  muscle  at  the  posterior  part  of  the  superior  fourth,  take  a  course 
like  the  arteries,  but  form  loops  at  the  ends,  from  which  delicate  filaments 
pass  off  and  encompass  the  primary  bundles  of  fibres. 

145.  d.  Classification  of  muscles. 

In  each  muscle  we  may  distinguish  the  fleshy  central  portion 
(belly) ;  the  origin,  the  fixed  point,  head  ;  the  insertion,  the  mov- 
ing point,  tail.  Both  the  last  are  provided  with  tendinous  fibres. 

1.  According  to  the  structure  we  distinguish  animal  and  organic  muscles. 
(See  before.) 

a.  The  animal  muscles  are  striated,  generally  dark  red,  attached  especially 
to  bones,  and  lie  on  the  external  boundary  of  the  body ;  they  are  connected 
by  tendons,  and  have  antagonist  muscles;  they  are  generally  thick,  cylindrical, 
sometimes  even  expanded  like  a  membrane ;  lastly,  they  are  stimulated  to 
motion  by  the  will.  To  this  class  belong  the  muscles  of  the  trunk  [and  ex- 
tremities] and  of  the  commencement  of  internal  canals. 

8.  The  inorganic  muscles  are  unstriped,  generally  pale  red,  lie  in  the  inte- 


THE  MUSCLES.  125 

rior  of  cavities  (chest  and  abdomen),  expanded  in  a  manner  resembling  and 
between  membranes,  without  tendons  and  antagonist  muscles.  They  are  not 
under  the  influence  of  the  will.  To  this  class  belong:  the  muscular  coats  of 
the  intestines  and  excretory  ducts ;  and  the  fibres  of  the  heart  which,  how- 
ever, belong  to  it,  only  in  relation  to  their  involuntary  movement 

2.  According  to  their  actions  we  distinguish — 

«.  Antagonising  muscles,  antagonistic;  for  example,  flexor  and  extensor 
muscles. 

/?.  Assosiated,  soa'i,  which  act  simultaneously  to  produce  a  certain  effect. 

y.  Flexors,  flexores,  and  Extensors,  extensores. 

£  Al>  and  Adductors,  ab-  and  adductores,  which  remove  parts  from,  or 
bring  them  to,  the  middle  line  of  the  body. 

t.  Rotators,  rotatores,  which  roll  a  part  upon  its  axis,  inwards  (jrronatores)  or 
outwards  (svpinatores) . 

3.  According  to  their  shape,  voluntary  muscles  are  distinguished,  as 

«.  Long  muscles,  which  arise  either  with  one,  two,  or  several  heads  or 
dentations  from  a  fixed  point,  form  one  or  more  thick  central  portions 
(belly),  and  are  attached  either  with  a  single  or  divided  ends  (tail)  to  the 
moveable  point 

0.  Flat,  broad  muscles,  are  thin,  tri-  or  quadrangular,  like  a  membrane,  lie 
on  the  parietes  of  cavities,  and  terminate  with  Aponeuroses ;  e.  g.,  the  abdo- 
minal muscles. 

y.  Closing,  circular  muscles,  sphincteres,  with  circular,  encompassing  primi- 
tive fibres,  lying  round  about  natural  openings;  e.  g.,  Sphincter  Ani. 

We  likewise  find,  among  the  class  of  involuntary  muscles,  layers  of  longi- 
tudinal and  circular  fibres,  with  others,  crossing  each  other  in  various  ways 
(hollow  muscles). 

146.  e.  Auxiliary  organs  of  muscles. 

1.  Tendons.     Their  fibres  are  not  continuations  of  the  mus- 
cular, but  are  only  embraced  by  them,  so  that  the  two  are  sepa- 
rated by  boiling;   even  the  capillary  vessels  of  the  muscles  do 
not  pass  into  them.     Sinews,  tetidines,  are  the  cord-like  tendons 
which  form  the  prolongations  of  the  muscles,  and  often  extend  to 
considerable  length.      When  the   muscular  fibres  are  continued 
upon  both  sides,  the  so-called  penniform  muscles  arise,  when  only 
on  one  side  the  semi-penniform. 

a.  Aponeuroses  are  flat  expansions  of  the  tendons,  which  occur  with  flat 
muscles,  and  which  are  generally  unitad,  as  they  lie  on  the  same  plane,  e.  g., 
on  the  skull. 

b.  Fascia  (also  called  aponeuroses),  tendinous  envelopes  for  the  muscles, 
surrounding  an  1  isolating  separate  muscles  anil  groups  of  muscles,  maintain- 
ing them  in  their  situation,  and  even  serving  for  their  attachment,  since  they 
send  oft",  in  many  places,  processes  to  the  bones  (ligg.  intermuscularia)  ;  also 
the  sinews  with  peculiarly  long  sheaths  (vaginae  tendinium  fibros;p).  or  pro- 
vided with  narrow  restraining  bands  (retinacula),  to  prevent  displacement. 

Fascia  superficLalis  is  such  an  envelope,  which  lies  close  beneath  the 
corium,  and  surrounds  all  superficial  muscles.  It  consists  of  fibrous  laminae 
crossing  each  othar.  and  interwoven  with  elastic  fibres,  between  which  lie  fat, 
superficial  nerves  and  vessels. 


126  SPECIAL  ANATOMY. 

147  •  2.  Fibro-cartilaginous  portions,  pulleys,  (trochlese),  and 
grooves,  on  which  the  tendons  in  several  places  glide,  to  prevent 
i'riction,  firmly  attached  by  both  extremities  to  the  bones. 

148.  3.  Serous  structures  on  the  tendons,  to  assist  their  free 
movement  over  bones,  cartilages,  &c.     There  are : 

a.  Mucous  sacs,  bursce  mucosce,  1.  synoviales,  generally  closed  sacs,  which 
lie  between  the  muscles  and  bones,  and  connected  with  both,  particularly  over 
joints,  into  which  they  frequently  open ;  e.  g.,  on  the  m.  subscapular  of  the 
shoulder  joint. 

b.  Mucous  sheaths,  vagina  mucosa  s.  synoviales,  long  (closed)  sacs,  through 
which  a  canal  passes  for  a  free  tendon,  with  which  it  is  connected ;  e.  g.,  Keeps 
brachii. 

I.  Muscles  on  the  Head. 

A.  Muscles  of  the  Cranium,  Occipito-frontalis  s.  Epicranius. 

149.  1.  Occipitalis,  Occipital  muscle. 

Shape:  obliquely  four-sided,  weak.  Position:  close  beneath 
the  skin  of  the  occipital  region.  Origin  from  linea  semicircular, 
superior,  extending  from  close  to  the  middle  line  to  the  base  of 
proc.  mastoid.  Insertion :  Galea  aponeurotica.  Action :  draws 
the  skin  of  the  head  backwards,  rendering  the  forehead  smooth. 

Nerves :  supraorbital,  supra  and  infra  trochleat .,  rr.  temporal,  n.  facialis. 

150.  2.  Frontalis,  Frontal  muscle. 

Shape:  obliquely  four-sided,  above  arched,  flat.  Position:  close 
beneath  the  skin  of  the  forehead,  from  the  root  of  the  nose  to  the 
frontal  eminence.  Before  the  Glabella  the  internal  borders  of 
both  meet  together.  Origin :  root  of  nose  and  arcus  superci- 
liaris.  Insertion:  Galea  aponeurotica.  Action:  elevates  the 
skin  of  the  forehead  and  eyebrows  (making  transverse  wrinkles), 
stretches  the  skin  of  the  back  of  the  nose  (by  means  of  the  so- 
called  procerus  nasi). 

Nerves :  occipital  major,  and  min.  auricular,  post. 

Galea  aponeurotica,  that  is,  the  tendinous  cap  which  lies  be- 
tween the  two  occipital  and  frontal  muscles,  formed  of  their  tend- 
ons, attached  besides  to  the  root  of  the  proc.  mastoid.  to  the 
zygomatic  arch  as  far  as  the  external  angle  of  the  eye,  intimately 
united  with  the  skin  of  the  head  (less  with  the  periosteum),  co- 
vered with  fat  (in  which  are  many  nerves  and  vessels).  Behind 
it  is  thick  and  brilliantly  white,  on  the  sides  thinner. 


THE  MUSCLES.  127 

B.  Muscles  of  the  external  Ears. 

151.  1 .  Attollens  auriculae,  elevator  of  the  ear. 

Shape:  triangular,  thin.  Position:  close  beneath  the  skin  of 
the  temporal  fossa  above  the  ear.  Origin:  Galea  aponeurotica. 
Insertion :  broad,  on  the  posterior  surface  (between  the  divisions) 
of  the  anthdix.  Action:  raises  the  auricle. 

152.  2.  Protrahens  s.  auricularis  anterior. 

Figure:  small,  thin.  Position:  above  the  zygoma,  beneath  he 
skin;  covers  art.  and  ven.  temporalis  and  fascia  temporal.  Origin : 
Galea  aponeurotica.  Insertion:  in  front  of  the  helix.  Action: 
draws  the  auricle  forwards  and  upwards. 

Nerves:  temporal  superfic.  {auricular,  anter)  subcutan.,  tempor.  facial. 

153.  3.  Retrahentes,  2  retractors  of  the  auricle. 

Figure:  roundish,  flat,  small.  Position:  above  the  origin  of 
the  Sterno-mastoid  muscle.  Origin :  proc.  mastoideus.  Inser- 
tion: the  external  convex  surface  of  the  auricle.  Action:  they 
draw  the  upper  portion  of  the  auricle  backwards. 

Nerves :  auricular,  post,  vagi,  occipital,  minor. 

154.  4.  Muscles  which  may  serve  for  the  movement  of  indi- 
vidual parts,  but  however  are  only  perceptible   as  exceptions. 
Helids  major  and  minor,  Tragicus,  Jlntitragicus,  Transversus 
auricula,  Dilator  conchas  (see  Ear).     Hyrtl  describes  a  m.  stylo- 
auricularis,  which  passes  from  proc.  styloideus  to  the  inferior  sur- 
face of  the  cartilaginous  meatus  audit  orius,  but  generally  repre- 
sented by  a  tendinous  cord. 

C.  Muscles  of  the  Eyelids. 

155.  1.  Orbicularis  s.  sphincter  palpebrarum. 

Figure:  flat,  rather  thin,  consisting  of  an  external  and  an  in- 
ternal layer.  From  the  internal  angle  of  the  eyes  a  four-sided 
fasciculus  passes,  m.  Horneri  s.  Tensor  tarsi  s.  sacci  lacrymalis, 
which  goes  behind  the  tarsal  ligament  around  the  lacrymal  canal 
to  the  crista  of  the  lacrymal  bone.  Position :  beneath  the  skin  of 
the  lids  and  borders  of  the  orbits.  The  internal  layer  arched  from 
Kg.  palpebrar.  intern,  to  externum.,  and  from  the  borders  of  the 
orbits  to  the  tarsal  cartilages,  covers  the  roots  of  the  cilia.  The 


128  SPECIAL  ANATOMY. 

external  (red)  layer  upon  the  borders  of  the  orbits  covers  corrugafor 
super  til.  parts  of  frontalis,  temporal.,  zygomaticus  and  levator 
labii  alseq.  nasi.  Origin:  the  internal  angle  of  the  eyes,  lig. 
palpebrale  internum.  Insertion :  the  same,  only  rather  farther 
towards  the  nose.  The  internal  layers  of  the  superior  and  the 
inferior  eyelids  are  separated  from  one  another.  Action :  the  in- 
ternal layer  closes  the  eye  and  presses  the  bulb  a  little  backwards. 
The  external  shortens  at  the  same  time  the  fissure  between  the 
lids,  and  corrugates  the  skin  at  the  internal  angle.  Horner's 
muscles  merely  draw  the  puncta  lacrymalia  deeper  inwards;  they 
may  also  compress  the  lacrymal  sacs. 

Nerves :  palpebraks  from  supra-,  infra-orbital. :  and  trochkar.,  lacrymal.,  sub- 
cutan.  mal.,  rr.  temporal,  n.  fadalis. 

156.  2.  Corrugator  supercilii. 

Figure:  arched,  narrow,  flat.  Position:  upon  the  arcus  super- 
ciliaris,  covered  by  frontalis  and  sphinct.  palpebr.  Origin:  the 
root  of  the  nose.  Insertion :  to  the  superciliary  arch  as  far  as  the 
temple.  Action :  draws  the  brow  inwards  and  downwards,  there- 
by corrugating  the  skin  over  the  root  of  the  nose  lengthwise. 

Nerves:  as  frontalis. 

157.  3.  Levator  palpebras  superioris. 

Figure:  long,  flat,  and  narrow.  Position:  between  the  roof  of 
the  orbits  and  the  rectus  bulbi  sup.;  above  it,  passes  n.  frontalis 
(trigem.).  Origin:  close  above  the  optic  foramen  from  alaparva 
of  the  sphenoid  bone  and  sheath  of  nerv.  opticus.  Insertion : 
with  a  broad  aponeurosis  to  the  superior  border  of  the  tarsus. 
Action :  draws  back  the  superior  lid  upwards,  particularly  on  ele- 
vation of  the  globe. 

Nerves:  oculo-motorius. 

D.  Muscles  of  the  Nose. 

158.  1.  Depressor  alas  nasi. 

Position:  close  upon  the  upper  jaw,  covered  by  sphinct.  oris 
and  levat.  labii  alxq.  nasi.  Origin:  before  the  roots  of  the  two 
incisor  and  the  canine  teeth.  Insertion:  the  posterior  part  of  the 
septum  mobile  and  the  alas.  nasi.  Action:  draws  the  inferior 
part  of  the  nose  downwards  and  backwards  (sulcus  naso-fabialis 
becomes  deeper.)  Fibres  from  it  penetrate  the  upper  lip;  these 
are  m.  Incisivus  (Cowperi)  superior. 


THE  MUSCLES.  129 


159.  2.  Compressor  narium  s.  transversus  nasi. 

Figure  :  below,  narrow  (fleshy),  above,  broad,  three-sided  (ten- 
dinous). Position  :  arched  upon  the  cartilaginous  part  of  the  nose, 
where  both  meet  together.  Origin :  between  the  roots  of  the 
canine  and  first  molar  teeth,  in  the  sulcus  naso-labialis.  Inser- 
tion :  the  back  of  the  nose  below  the  bony  portion.  Action: 
rather  to  compress  the  nose,  drawing  the  skin  downwards,  and 
widening  the  nasal  openings. 

Nerves:  infraorbital.  and  elhmoidalis. 

160.  3.  Dilatator  narium  posterior. 

Fig.:  small.  Pos.:  at  the  posterior  part  of  the  alae  nasi, covered 
by  depressor  and  compressor.  Or.:  the  border  of  the  proc.  ascend. 
of  the  upper  jaw.  Ins. :  below  to  the  skin  of  the  posterior  half 
of  the  nasal  openings.?  Act. :  widens  behind  the  nasal  openings. 

161.  4.  Dilatator  narium  anterior. 

Pos. :  on  the  alae  close  to  the  back  of  the  nose.  Or. :  the  supe- 
rior border  of  the  alar  cartilages  of  the  nose.  Ins. :  the  skin  of 
the  anterior  part  of  the  border  of  the  nasal  openings.  Act. : 
draws  the  anterior  portion  of  the  alas  nasi  outwards. 

Nerves :  infraorbital  and  fadalis. 

Remarks.  The  rest  of  the  nasal  muscles  are  not  independent,  but  continu- 
ations of  neighboring  muscles;  viz. 

a.  Procerus  (s.  pyramidaKs)  a  continuation  of  frontatis,  upon  the  dorsum  of 
the  nose.     Act. :  draws  the  skin  of  the  back  of  the  nose  upwards,  stretching  it. 

b.  Depressor  septi  mobilis  a  portion  of  sphincter  oris,  in  the  fossa  of  the  upper 
lip.     Act:   draws  the  point  of  the  nose   upwards;    contracting   the   nasal 
openings. 

c.  Pyramidalis  s.  Levator  labii  superioris  alaqui  nasi. 

E.  Muscles  of  the  Lips,  the  Cheeks,  and  the  Chin. 

162.  1.  Orbicularis  s.  sphincter  oris,  the  muscle  closing 

the  mouth. 

Pos.:  round  about  the  oral  fissure  in  the  lips,  between  the 
mucous  membrane  and  the  external  skin ;  connected  on  the  ex- 
ternal circumference  with  the  rest  of  the  labial  muscles  (whose 
continuation  it  forms).  Or.  and  Ins.:  septum  mobile  nasi.  Act. : 
closes,  points,  and  presses  the  lips  against  the  teeth  (m.  osculato- 
rius]. 

Nerves:  infraorbit.,  mental.,  buecinat.,  facial. 


130  SPECIAL  ANATOMY. 


163.  2.  Buccinator,  cheek  muscles. 

Fig1.:  oblong,  broad,  flat.  Pos.:  between  upper  and  lower  jaw; 
behind  covered  by  the  ramus  of  the  lower  jaw,  masseter  and  tem- 
poralis ;  before  by  zygomatici,  risorius ;  perforated  by  duct. 
Stenonian.  (opposite  the  three  superior  molar  teeth) ;  covered  in- 
ternally by  the  buccal  mucous  membrane.  Or. :  1.  Over  the  last 
molar  tooth.  2.  Hamulus  of  proc.  pterygoid.  3.  Mveolus  of 
the  upper  and  lower  jaws.  Ins.:  sphincter  oris.  Act.:  draws 
the  angles  of  the  mouth  outwards;  contracts  the  buccal  cavity  (in 
whistling,  blowing). 

Nerves:  buccinator,  buccalcs,  facialis. 

164.  3.  Levator  labii  superioris  alseque  nasi, 

(Pyramidalis  of  Theile.) 

Fig. :  flat,  divided  below.  Pos.  :  on  the  side  of  the  nose,  some- 
what covered  above,  by  sphincter  palpebr.,  then,  below,  by  the 
skin,  above,  compressor  and  depressor  alas  nasi.  Or. :  proc.  frontal. 
of  upper  jaw  to  lig.  palpebr.  intern.  Ins. :  the  stronger  portion 
to  sphincter  oris,  the  weaker  to  the  ala  nasi.  Act. :  elevates  the 
ala  nasi,  corrugates  the  nasal  membrane,  and  raises  the  upper  lip 
at  the  same  time. 

165.  4.  Levator  labii  superioris  proprius  s.  Incisorius. 

Fig. :  flat,  four-sided,  broader  above.  Pos. :  covered  above  by 
sphinct.  palpebr.,  then  only  by  the  skin  on  the  external  border  of 
this  muscle,  on  the  inner  of  the  zygomatic  minor,  with  which  it 
is  united  below.  Or. :  above  foram.  infraorbitale.  Ins. :  sphincter 
oris  and  skin  of  upper  lip.  Act. :  elevates  the  upper  lip. 

166.  5.  Levator  anguli  oris  (s.  Caninus). 

Pos. :  vertical ;  external  to  the  one  last  described  ;  covered  by 
it,  below  free.  Or. :  half  an  inch  below  'foram.  infraorb.,  broad. 
Ins. :  sphincter  oris,  depressor  labii  inferior.  Act. :  raises  the 
angle  of  the  mouth  somewhat  inwards. 

167.  6.  Zygomaticus  minor,  small  zygomatic  muscle, 

sometimes  wanting. 

Pos. :  oblique,  at  commencement  covered  by  orbic.  palpebr., 
upon  the  last  described,  free  beneath  the  skin.  Or.:  os  zygo- 
matic. Ins. :  the  upper  lip ;  mingling  with  levator  labii  prop. 
Act. :  raises  the  upper  lip  and  draws  it  somewhat  outwards. 


THE  MUSCLES. 

168.  7.  Zygomaticus  major,  greater  zygomatic  muscle. 

Pos. :  oblique ;  external  and  below  the  last  described ;  covered 
below  by  the  fat  of  the  cheek,  above  by  orbicular palpebr.  Or.: 
05  zygomatic.  Ins. :  the  angle  of  the  mouth.  Act. :  draws  the 
angle  of  the  mouth  outwards  and  upwards. 

169.  8.  Depressor  anguli  oris  (s.  triangularis  menti). 

Pos. :  beneath  the  skin  at  the  sides  of  the  chin ;  covers  the  qua- 
drat, menti  internally,  the  buccinator  externally.  Or.:  broad, 
from  basis  maxill.  infer.  Ins. :  pointed,  to  the  angle  of  the  mouth 
(levator  anguli  and  zygomatic.  major].  Act. :  draws  the  angle 
of  the  mouth  outwards  and  downwards  (physiognomy  of  the  sim- 
ple). 

170.  9.  Risorius  (Santorini),  laughter  muscle,  thin,  three- 

sided. 

in  the  fat  of  the  cheeks,  upon  m.  platysmam.  Or.:  fascia  mas- 
seter.  Ins.:  m.  zygomatic.  major.  Act.:  draws  the  inferior 
internal  part  of  the  cheeks  outwards  and  upwards,  so  that  (in 
laughing)  a  small  fossa  is  formed  in  the  skin. 

171.  10.  Depressor  labii  inferioris  (s.  quadratus  menti). 

Pos. :  close  beneath  the  skin  of  the  chin,  covers  the  sphincter 
oris  and.  lev.  menti.  Or.:  the  inferior  border  of  the  chin.  Ins.: 
the  under  lip.  Act. :  draws  the  under  lip  downwards,  both  to- 
gether stretch  it. 

172.  11.  Levator  menti. 

Pos. :  in  the  chin,  bounded  above  by  the  sphincter  oris,  covered 
externally  by  quadratus;  in  the  centre  the  fibres  of  both  sides  pass 
over,  above,  in  an  arched  manner,  into  one  another;  below,  they 
are  united  by  firm  fibro-cellular  tissue,  and  free.  Or.:  below  the 
corner  tooth  of  the  lower  jaw.  Ins.:  skin  and  fat  of  the  chin. 
Act.:  draws  the  skin  of  the  chin  upwards,  corrugates  it,  and 
pushes  up  the  lower  lip.  Its  most  superior  fibres  (m.  incisivus 
inferior)  penetrate  the  under  lip,  and  are  said  to  compress  it 
against  the  gums. 

173.  12.   Transversalis  menti, — wanting  in  feeble  subjects. 

Pos. :  transverse  below  the  free  border  of  the  chin,  upon  m.  pla- 
tysmam. Or.:  continuation  of  triangularis  menti.  Ins.:  the 
internal  angle  of  both  mm.  triangular -es.  Act.:  stretches  the 
skin  on  the  chin. 

Nerves:  (for  three  to  twelve)  facialis ;  for  the  superior  muscles;  infra 
orbital,  and  subcutan.,  for  the  inferior;  mentaUs. 


132  SPECIAL  ANATOMY. 

F.  Muscles  of  the  Lower  Jaw, — of  mastication, 
mansores  s.  manducatores. 

174.  1.  Masseter,  masticating  muscle;  external  and  internal 

portion. 

Pos. :  before  and  upon  the  ramus  maxill.  infer.,  between  arcus 
zygomat.  and  angulus  maxill.;  above,  covered  by  zygomatic 
major;  behind,  by  the  Parotis.  Close  to  its  anterior  border  be- 
low :  art.  maxillar.  extern.  Or. :  the  inferior  border  of  the  zygoma. 
Ins. :  angle  and  external  surface  of  ram.  maxill.  infer.  Act. : 
draws  the  lower  jaw  (very  strongly)  upwards. 

175.  2.  Temporalis  (s.  crotaphites),  temporal  muscle. 

Pos.:  fills  up  the  temporal  fossa;  covers  m.  pterygoid.  extern., 
buccinator  (somewhat),  art.  maxillar.  intern,  and  vasa  temporall. 
proff.  Or. :  linea  semicircularis  and  the  walls  of  the  temporal 
fossa.  Ins.:  process,  coronoid.  of  the  lower  jaw.  Act.:  draws 
the  lower  jaw  upwards,  and  the  condyl.  maxill.  backwards  into 
the  articular  fossa. 

176.  3.  Pterygoideus  internus  (s.  major)  thick,  four-sided, 

(masseter  internus). 

Pos.:  in  the  fossa  zygomat.,  along  the  inner  surface  of  the 
ramus  maxill.  infer.,  separated  from  it  by  nn.  denial.,  lingual., 
art.  and  ven.  denial,  infer.,  and  lig.  laterale  intern.  External  to 
m,.  circumflex,  palali,  gland.  submaxiUar.  and  pharynx.  Or. : 
fossa  pterygoidea.  Ins.:  angulus  maxilla?  (internal  surfaces). 
Act.:  draws  the  lower  jaw  strongly  upwards,  as  well  as  rather  in- 
wards. 

177.  4.  Pterygoideus  externus  (s.  minor),  short  and  thick. 

Pos.:  horizontal  between  ala  externa  proc.  pteryg.  and  collum 
maxill.  infer.; — on  the  outer  side  of  pterygoid.  intern.,  inside  of 
ram.  maxill.  and  m.  temporalis.  Or. :  by  two  heads  (which  fre- 
quently embrace  art.  maxill.  intern.)',  a.  from  the  external  surface 
of  ala  extern,  proc.  pterygoid.  and  proc.  pyramid,  oss.  palati.  b. 
from  the  crista  and  spina  alse  m.agnse  of  the  sphenoid  bone,  be- 
tween fossa  temporal,  and  zygomatica.  Ins. :  the  depression 
before  the  collum  condyli  maxill.,  and  the  circumference  of  the 
interarticular  cartilage.  Act.:  draws  the  lower  jaw  forwards  and 
pushes  it  to  the  other  side;  both  acting  together  draw  it  directly 
forwards. 

Nerves:  (for  one  to  four)  ramus  3  trigemini. 


THE  MUSCLES.  133 

Fasciae  of  the  Head. 

178.  1.   Galea  capitis.     See  before. 

179.  2.  F.  temporalis,  is  covered  at  the  upper  part  by  the 
Galea,  but  is  not  even  connected,  where  free,  with  the  external 
skin.     It  covers  the  temporal  muscle,  dividing  inferiorly  into  a 
superficial  delicate  layer  which  is  attached  to  the  superior  border, 
and  a  deep  one,  to  the  internal  surface  of  the  zygomatic  arch; 
between  the  two  there  is  fat  and  a  branch  of  the  art.  temporalis; 
between  it  and  the  temporal  muscle  likewise  much  fat.     It  is  very 
dense.    (Pus  does  not  readily  penetrate  it,  but  it  gravitates  towards 
the  malar-maxillary  fossa.) 

180.  3.  F.  buccalis:  a.  Superficial  layer,  that  is,  F.  parofi- 
dsea,  very  dense,  especially  on  the  external  surface  of  the  Parotis, 
covering'it  like  a  sheath  (pus  does  not  penetrate  it  and  the  skin 
easily);  continuing  as  F.  masseterica,  where  behind  it  appears  to 
divide,  covering  the  m.  masseter  and  ductus  Stenonianus,  above 
and  in  front  losing  itself  in  fibro-cellular  tissue.     (Pus  behind  it 
sinks  towards  the  neck,  that  before  it  comes  to  the  skin.) 

181.  b.  Deep  layer,  F.  bucco-pharyngea,  covers  m.  buccina- 
tor, serving  anteriorly  for  the  attachment  of  this,  posteriorly  much 
thicker,  for  that  of  the  m.  constrictor  pharyngis  super.,  since  it 
passes  away  behind  m.  pterygoid.  intern.,  and,  like  a,  is  con- 
nected with  the  F.  cervicalis.     It  separates  the  muscles  from  the 
buccal  mucous  membrane.     (Pus  does  not  easily  find  its  way 
through  these  fasciae  towards  the  mouth  and  the  reverse.) 

II.  Muscles  of  the  Neck. 
A.  Superficial  cervical  muscles. 

182.  1.  Platysma-myoides  (s.latissimuss.  subcutaneous  colli). 

Pos. :  broad,  close  behind  the  skin,  below  firmly,  above,  united 
with  it  by  fat,  on  the  sides  of  the  neck,  before  ihefasc.  cervicalis. 
The  two  diverge  from  above  downwards.  Or. :  the  anterior  supe- 
rior part  of  the  chest  (two  to  three  ribs)  before  m.  pectoralis  major. 
Ins. :  Basis  maxill.  infer.,  angle  of  mouth,  Masseter,  skin  of  the 
face.  Act. :  draws  the  skin  of  the  neck,  somewhat  the  lower  jaw 
and  under  lip,  downwards. 

Nerves :  subcutanti,  colli  supraclaviculares. 

183.  2.  Sterno-cleido-mastoideus. 

Pos. :  above  at  the  sides,  below  on  the  anterior  surface  of  the 
neck;  covered  by  the  skin,  by  m.  platysma  my  old.,  separated 


134  SPECIAL  ANATOMY. 

from  the  last  by  Vena  jugular,  extern,  and  Plex.  nerv.  cervical, 
superfic.  Behind  it,  1.  Mm.  sterno-hyoideus,  thyreoid.,  omo- 
hyoid.,  splenius,  digastricus,  scaleni.  2.  Nn.  vagus  and  acces- 
sor., sympathicus,  hypoglossus,  cervicales.  3.  Carotis  commu- 
nis,  Vena  jugular,  intern.  On  the  anterior  border  above,  Parotis. 
The  two  diverge  from  below  upwards.  The  posterior  border 
forms  with  the  Clavicula  an  acute  angle,  with  these  and  the  M. 
trapezius  a  triangle.  Or.:  two  portions.  1.  Cleido-mast.  from 
the  internal  extremity  of  the  Clavicula.  2.  Sterno-mast.  from 
manubrium  sterni.  Ins. :  external  surface  of  Proc.  mastoid.  oss. 
temporis  and  linea  semicircular,  superior  oss.  occipitis.  Act.  : 
both  together  draw  the  head  directly  forwards  and  downwards, 
bowing  it;  one  alone  acting  draws  it  in  such  a  direction  that  the 
face  looks  towards  the  opposite  side. 

Nerves :  accessor.  Willis.,  plexus  cervical. 

a.  Below  the  Os  Hyoides. 

184.  3.  Sterno-hyoideus  (often  double). 

Pos. :  vertical  in  the  centre  of  the  neck ;  covered  by  M.  platys- 
mam.,  sterno-cleidom.  and  fascia  cervicalis,  before  the  deep  cervi- 
cal muscles  and  Art.  thyreoidea  superior.  The  inner  borders 
meet  together.  Fig.:  flat,  riband-like,  thin.  Or.:  the  posterior 
surfaces  of  the  Sternal  ends  of  the  Clavicula  (frequently  the 
Manubrium  sterni}.  Ins.:  the  inferior  border  of  the  body  of  os 
hyoides,  close  to  the  middle  line,  to  the  inside  of  M.  brachyoideus. 
Act. :  draws  the  os  hyoid.  downwards. 

185.  4.  Omo-hyoideus  (sometimes  wanting). 

Pos. :  oblique  on  the  side  of  the  neck,  commencing  parallel 
with  the  Clavicula,  then  forming  an  obtuse  angle  upwards  and 
inwards ;  covered  by  trapezius,  subclavius,  platysmam.,  sterno- 
cleido-mast. ;  it  crosses  Mm.  scaleni,  the  Plex.  brack.,  Ven.  jugu- 
lar, intern.,  Carotis  comm.,  near  m.  sterno-hyoideus.  Or. :  Sca- 
pula (the  superior  border)  behind  the  Incisura  scapulae.  Ins. : 
external  and  close  to  the  before-described  muscle.  Fig. :  two- 
bellied,  in  the  centre  tendinous,  angular.  Act.:  the  superior 
belly  draws  the  hyoid  bone  downwards.  The  posterior  belly  is 
said  to  stretch  thefasc.  cervic.  which  attaches  it  to  the  clavicle. 

[Coraco-cervicalis  (Krause),  a  small  m.  before  m.  omo-hyoideus, 
arises  from  Proc.  coracoid.,  and  is  attached  to  the  fascia  cervi- 
calis,  which  it  stretches.] 


THE  MUSCLES.  135 

186.  5.   Sterno-thyreoideus. 

Pos. :  behind  sterno-hyoid,  diverging  from  below  upwards, 
before  the  thyroid  gland.  On  the  outer  border:  V.  jugular 
intern.;  behind  that  Carot.  comm.;  on  the  inner  border:  V.  thy- 
reoid  media.  Or.:  broad  from  Manubrium  sterni  (posterior 
surface)  and  first  rib  cartilage.  Ins. :  Lima  obliqua  of  thyroid 
cartilage.  Act. :  draws  the  larynx  downwards,  shortening  the 
trachea. 

Nerves :  (three  to  five)  hypoglossi  ram.  descendens. 

187.  6.   Thyro-hyoideus. 

Pos. :  behind  the  m.  sterno-hyoideus,  vertical  before  the  memb. 
thyreoidea.  Or. :  os  hyoides  (the  inferior  border  of  the  body 
and  root  of  great  cornua).  Ins. :  Thyroid  cartilage  (linea 
obliqua).  Act. :  approximates  hyoid  bone  and  larynx;  assists 
in  throwing  the  epiglottis  backwards. 

\_Thyreoideus  is  a  prolongation  of  the  thyroid  gland  upwards; 
it  contains  no  muscular  fibres.] 

Nerves :  laryngeus  superior  and  hypoglossus. 

b.  Above  the  Os  Hyoides. 

188.  7.  Digastricus  (s.  biventer  maxillae  inferioris). 

Pos. :  in  the  semicircle  between  the  temporal,  hyoid  bone  and 
centre  of  lower  jaw,  below  the  angle  of  the  last;  covered  by  M. 
platysma  myoides;  behind  by  the  Parotis  and  Gland,  submaxill. 
Internally  to  it  lie  Carotis  interna  and  N.  hypogloss. ;  the  pos- 
terior belly  perforates  on  the  hyoid  bone,  the  M.  stylo-hyoidcus . 
Or.:  1.  Post,  belly:  from  Incisura  mastoidea,  covered  by  M. 
sterno-cleido-mastoid.  2.  Anterior  belly :  from  os  hyoides.  Ins. : 
1.  Os  hyoides.  2.  Lower  jaw  (base).  Act.:  the  anterior  belly 
elevates  the  hyoid  bone  towards  the  lower  jaw,  the  post,  draws 
it  backwards  and  upwards. 

Nerves:  post  belly, facialis ;  [ant.  beHy,  trigenrinus.] 

189.  8.  Stylo-hyoideus. 

Pos. :  between  temporal  and  hyoid  bones,  covered  externally 
by  the  posterior  belly  of  the  digastric  muscle  by  which  it  is  per- 
forated shortly  before  its  point  of  insertion.  Or. :  Proc.  styloideus 
(the  centre  of  the  external  surface).  Ins.:  the  Os  hyoides^  at  the 
union  of  its  great  cornu  with  the  body.  Use :  to  draw  the  hyoid 


136  SPECIAL  ANATOMY. 

bone  obliquely  backwards  and  upwards ;  elevates  the  root  of  the 
tongue,  and  contracts  the  isthm.  faucium. 
Nerves :  facialis. 

190.  9.  Mylo-hyoideus  (s.  transversus  mandibulse}. 

Pos. :  extended  like  a  partition  from  the  lower  jaw  to  the  hyoid 
bone;  above  M.  digastric,  (ant.  belly)  and  Gland,  submaxil- 
lar.;  beneath  Mm.  genio-hyoid.,  hyo-,  stylo- glossus,  Nn.  lin- 
gualis  and  hypo- glossus,  Gland,  subling.  and  oral  mucous  memb. 
Or.:  broad  from  the  entire  Lin.  obliq.  interna  of  the  lower  jaw. 
Ins. :  pointed  to  the  centre  of  the  body  of  the  hyoid  bone. 
[Meets  its  fellow  in  the  middle  line  of  the  body.]  Use:  draws 
the  hyoid  bone  upwards,  or  the  lower  jaw  downwards. 

Nerves:  trigeminus. 

191.  10.  Genio-hyoideus. 

Pos. :  above  the  last  771.,  beneath  m.  genio- glossus,  between 
chin  and  hyoid  bone,  below  and  behind.  Or. :  the  chin  (spina 
tnentalis  interna).  Ins. :  Hyoid  bone  (the  superior  anterior  part 
of  the  centre).  Use :  draws  the  hyoid  bone  forwards  and  upwards, 
or  the  lower  jaw  downwards. 

Nerves :  hypoglossus. 

B.  Muscles  of  the  Tongue,  of  the  Pharynx,  and  Palate. 

192.  1.  Linguales,  Tongue  muscle. 

a.  Longitudinalis  superior,  anteriorly  beneath  the  thick  mem- 
brane of  the  tongue,  behind  beneath  the  glandular  layer,  along 
the  entire  dorsum  of  the  tongue.     Use:  to  shorten  the  tongue, 
curving  the  apex  upwards  and  backwards. 

b.  Longitudinalis  inferior  (especially  the  lingualis],  spindle- 
shaped  on  the  under  surface  close  to  the  middle  line,  between 
genio-  and  hyo-glossi.     Use:  to  shorten  the  tongue,  curving  the 
point  downwards. 

2.  Transversus,  springs  from  the  fibrous  septum  in  the  centre 
of  the  tongue;  its  fibres  cross  each  other;  lies  between  the  two 
longitudinales.  Use:  to  narrow,  elongate,  and  point  the  tongue. 

193.  2.  Stylo- glossus. 

Pos. :  obliquely  inwards,  downwards,  and  forwards,  partly  on 
the  borders,  partly  transverse  in  the  tongue.  Externally  lie :  M. 
stylo-hyoideus,  Parotis,  M.  pterygoid.  intern.,  Gland,  sublin- 
gual,  N.  lingualis,  mucous  membrane  of  the  tongue.  Internally : 
Lig.  stylo-hyoid.,  Tonsilla,M.  constrictor pharyng.  super.,  hyo- 


THE  MUSCLES.  137 

glossus.  Or.:  Proc.  styloideus  (apex).  Ins.:  double  in  M. 
lingualis.  Use:  to  draw  the  tongue  upwards  and  to  its  own 
side.  Both  acting  together  draw  it  upwards  and  backwards, 
making  it  appear  broad. 

Nerves:  hypoglossus. 

194.  2.  Hyo-glossus  (Basic-,  Kerato-,  Chondro- glossus}. 
Pos. :    vertical,  above  M.  mylo-hyoideus.     Externally :    M. 

stylo-gloss.,  digastricus,  Gland,  subling.,  Nn.  hypogloss.  and 
lingualis.  Internally :  Art.  lingual.,  M.  geniogloss,  constrict, 
med.  Or.:  three-fold  from  the  hyoid  bone;  1.  from  body;  2. 
from  greater;  3.  from  lesser  cornu.  Ins.:  root  of  tongue  (m. 
lingualis).  Use:  to  draw  the  tongue  downwards  and  back- 
wards ;  both  acting,  draw  it  down  and  narrow  it. 

195.  4.   Genio-glossus  \_Genio-hyo-glossus~]. 

Pos. :  close  above  M.  genio-hyoideus,  horizontal,  beneath  the 
oral  mucous  membrane  and  the  tongue.  On  the  inside  both 
meet  together.  Outside :  Gland,  subling.,  N.  hypogl.,  and  the 
muscles  before  mentioned.  Fig. :  thick,  three-sided,  large.  Or. : 
chin  (spina  interna).  Ins.:  tongue.  The  posterior  fibres  pass 
to  the  hyoid  bone,  the  anterior  curved  from  the  root  to  the  apex 
of  the  tongue  to  the  m.  lingualis.  Use:  both  extend  the  tongue 
forwards,  draw  it  again  backwards,  and  press  it  together  to  form 
a  furrow. 

Xerves:  (three  to  four)  lingual,  trigenrini,  glosso-pharyng.  and  hypoglossus. 

196.  5.   Constrictores  pharyngis,  three  constrictors  of  the 

pharynx, 

form  the  posterior,  muscular  parietes  of  the  pharynx,  in  the 
centre  of  which  they  meet  together  in  a  white  line  [raphe]  formed 
of  fibro-celhilar  tissue.  From  behind  we  first  see  : 

a.  Constrictor  pharyngis  inferior,  the  strongest  of  the  three 
muscles,  extending  the  lowest  downwards.     Its  fibres  pass  from 
the  raphe  downwards,  outwards,  and  forwards,  blending  imme- 
diately with    those  of  the    O3sophagus    (see    Splanchnol.),    and 
reaching  above  to  the  constrictor  superior.    Inferior  attachments  : 
1.   Cartilago  cricoidea  (thence,  crico-pharyngeus}.     2.   C.  thy- 
reoidea   (M.   thyreo-pharyngeus).      3.    Lig*   hyo-thyreoideum 
later  ale    (M.    syndesmo-pharyngeus).     Superior    attachments : 
raphe. 

b.  Constrictor  pharyngis  medius. — Inf.    attach.:    1.    Cornu 
maj.  oss.  hyoid ei   (thence,  M.  cerato-pharyngeus).     2.   Cornu 
minus  oss.  hyoidei  (thence,  M.  chondro-pharyngeus).     Superior 
attach.:   1.  raphe.     2.   Oss.  occipitis  pars  basilaris. 


138  SPECIAL  ANATOMY. 

c.  Constrictor  pharyngis  superior.  Inf.  attach. :  1.  Mucous 
membrane  of  pharynx.'  2.  M.  stylo-pharyngeus  with  horizontal 
fibres ;  terminating  on  the  thyroid  cartilage  covered  by  Constr. 
inf.  Superior  attach.:  1.  Proc.  pterygoideus-hamulus  and  ala 
internet  (therefore,  pterygo-pharyngeus).  2.  M.  buccinator 
(bucco-pharyngeus).  3.  Linea  obliq.  maxill.  inf.  (therefore, 
mylo-pharyngeus).  4.  M.  genio  glossus  (therefore,  genio-  and 
glosso-pharyngeus).  Use:  to  press  the  posterior  walls  of  the 
pharynx  together  and  to  contract  it. 

Nerves :  glosso-pharyngeus  and  vagus. 

197.  6.   Stylo-pharyngeus  (s.  levator  pharyngis). 

Pos. :  oblique  from  above,  downwards  and  inwards,  between 
m.  stylo-hyoid  and  digastricus  (behind)  and  m.  stylo-glossus 
(before).  Externally  lie,  m.  stylo  gloss.,  carotis  externa  and 
parotis ;  internally,  carols  intern,  and  V.  jugular,  int.;  along 
the  outer  side,  n.  glosso-pharyngeus.  Or. :  round,  from  Proc. 
styloideus  (inner  surface).  Ins. :  between  the  fibres  of  mm.  con- 
strictor sup.  and  med.,  the  last  of  which  covers  it.  Use:  to 
raise  and  widen  the  pharynx  above  the  hyoid  bone. 

Nerves :  glosso-pharyngeus. 

198.  7.  Levator  palati  mollis  (s.  peristaphylinus  internus 

s .  p etro-salpingo-stap hylinus). 

Pos.:  obliquely  inwards,  forwards,  and  downwards  on  the  ala 
interna  of  Proc.  pterygoideus.  Or. :  the  petrous  bone  (apex) 
and  cartilaginous  portion  of  tuba  Eustachii.  Ins. :  between  the 
layers  of  the  soft  palate,  behind  m.  pharyngo-palatinus.  Use : 
to  draw  the  velum  pendulum  palati  upwards  towards  the  poste- 
rior nasal  openings,  by  which  these  are  contracted,  and  the  pas- 
sage of  the  fauces  widened. 

199.  8.   Circumflexus  s.  tensor  palati  mollis  (s.  perista- 
phylinus externus,  spheno-salpingo-staphylinus). 

Pos. :  close  to  the  outer  side  of  the  last,  separated  by  the  ala 
interna  Proc.  pteryg.;  the  tendon  passes  away  below  the  Ha- 
mul.  Proc.  pterygoid.  inwards,  at  a  right  angle.  Or. :  Proc. 
spinosus  of  sphenoid  bone,  tuba  Eustachii  (cartilage).  Ins. : 
before  the  last,  with  a  thinner  aponeurosis.  '  Use  :  both  draw  the 
velum-palati  in  a  transverse  direction,  outwards.  Whether  it 
serves  this  purpose,  or  for  widening  the  posterior  nasal  openings 
and  the  tuba  JSustachii,  is  doubtful. 

200.  9.  Jlzygos  uvulae  (s.  palato-staphylinus  [s.  levator es 

uvult£.~]) 
Pos. :    vertical  in   the   uvula,   below   the   last.     Or. :    spina 


THE  MUSCLES.  139 

nasalis  posterior.     Ins. :    raucous    membrane   of  uvula.     Use : 
to  raise,  shorten,  and  also  curve  the  uvula. 

201.  10.  Glosso-palatinus  (s.  constrictor  isthmi  faucium.) 
Pos. :  in  the  anterior  palatine  arch  [or  pillar  of  the  fauces], 
between  the  palate  and  tongue,  small  and  narrow.  Or. :  the  sides 
of  the  root  of  the  tongue  (m.  stylo  glossus).  Ins.:  the  soft  palate 
(blending  with  m. phatyngo-palatin).  Use:  to  approximate  the 
palate  and  tongue,  and  thereby  contract  the  fauces. 

202t  11.  Pharyngo-palatinus  (s.  constrictor  isthmi  faucium 
superior). 

Pos. :  in  the  posterior  palatine  arch,  below,  m.  levator  palati 
(above) ;  internal  to  the  other  palatine  muscles,  covered  by  the 
mucous  membrane.  Or. :  from  the  posterior  border  of  the  thy- 
roid cartilage  ascending  behind  the  tonsil  glands.  Ins. :  the  soft 
palate  (m.  levator  and  circumflexus  palati).  Use:  to  draw  the 
soft  palate  down,  or  the  posterior  wall  of  the  pharynx  upwards 
(as  in  swallowing). 

C.  Deep  Cervical  Muscles, 
a.  Anterior. 

203.  1.  Longus  colli. 

Pos.:  on  the  anterior  lateral  surfaces  of  the  vertebra,  behind: 
Pharynx,  (Esophagus,  Art.  carotis  and  Ven.  jugular  intern., 
nn.  vagus  and  sympathicus.  Or. :  from  the  ninth  to  the  sixth 
vertebral  body  and  transverse  processes  with  an  inferior  and 
superior  portion. 

Ins. :  the  anterior  surface  of  the  fifth  to  the  first  vertebral  body 
(tuberculum  atlantis  anticum).  Use :  to  flex  the  neck  (and  head)* 
if  both  act ;  one  alone  acting  draws  it  in  such  a  direction  that  the 
face  looks  to  the  opposite  side. 

204.  2.  Rectus  capitis  anticus  major. 

Pos. :  close,  external  to  and  above  the  last  muscle,  before  m. 
rect.  capt.  ant.  minor.  Or. :  from  the  front  of  the  Proc.  trans- 
vers.  vertebr.  from  the  third  to  the  sixth.  Ins. :  close  in  front 
of  for.  magn.  occipit.  Use:  to  flex  and  rotate  the  head  some- 
what sideways. 

205.  3.  Rectus  capitis  anticus  minor. 

Pos. :  oblique,  behind  and  next  to  the  last  muscle,  behind  the 
Ganglion  I.  cervic.  n.  sympathici ;  in  front  of  the  articulation  of 
the  atlas  with  the  occipital  bone.  Or. :  Mas  (radix,  anter.proc. 


140  SPECIAL  ANATOMY. 

transversi).     Ins. :  Pars  basilaris  occipitis.     Use  :  to  bend  the 
head  somewhat  to  the  side  and  forwards. 

b.  Lateral. 

206.  4.  Rectus  capitis  later  alls. 

Pos. :  vertical  (behind,  V.  jugularis,  before,  Art.  vertebral.}-, 
behind  the  pharynx,  before  obliq.  capit  super.,  to  the  inside  of 
biventer  maxilliE.  Or. :  Proc.  transvers.  Atlantis,  outside  the 
last  muscle.  Ins.:  os  occipitis;  between  for  am.  jugular  e  and 
stylo-mastoid.  Use  :  bends  the  head  to  the  side. 

207.  5.  Scalenus  anticus. 

Pos. :  below  and  behind  Muse,  and  Ven.  subdavia,  above  and 
behind  m.  sterno-mastoid,  Omo-hyoid.,  n.  phrenicus,  art.  cerv. 
trans,  and  ascend.;  before,  a  triangular  space,  at  the  base  of 
which,  below,  Art.  subdavia;  in  the  apex:  Plexus  brachialis. 
Internally,  Art.  vertebr.  and  m.  longus  colli  ;  externally,  scalen. 
med.;  rests  upon  the  apex  of  the  pleura.  Or. :  Proc.  trans,  vertebr. 
3  to  6.  Ins. :  Costa  I.  (superior  border)  even  to  the  centre.  Fig.  : 
conical,  the  apex  above.  Act. :  bends  the  neck  forwards ;  or 
raises  the  first  rib. 

208.  6.   Scalenus  medius  (the  strongest  of  the  three 

supporters  of  the  ribs). 

Pos. :  behind  the  last  muscle,  Art.  subdavia  and  Plex.  bra- 
chialis ;  upon  it  lie  :  omo-hyoid,  and  above,  the  m.  Sterno-deido- 
mast.  Or.:  Proc.  transv.  Vv.  1  to  7  (the  anterior  tubercles). 
Ins. :  Costa  I.  (superior  border,  outside  the  last  muscle),  and  Costa 
II.  Use  :  to  raise  the  first  and  second  rib  ;  to  incline  the  neck 
laterally  ;  both  fix  the  neck. 

209.  7.  Scalenus  posticus. 

Pos.:  behind  and  outside  the  last  muscle,  before,  cervical, 
descendens.  Or. :  Proc.  transv.  Vv.  5  to  7.  Ins. :  Costa  II. 
(behind  the  centre).  Use :  bends  the  neck  sideways,  or  raises 
the  second  rib. 

Nerves :  (1 — 7)  rr.  anteriorr.  n.  cervicall. 

210.  Fascia  cervicalis. 

Arises  from  the  anterior  belly  of  digastric,  as  far  as  the  chin, 
from  the  os.  hyoides,  from  the  lower  jaw,  below  gland,  submaxil- 
lar.,  to  the  angle  between  it  and  Parotis ;  from  proc.  styloid.  and 
its  muscles.  Insertion  :  the  superior  border  of  the  chest.  Posi- 
tion :  covered  by  platysmam.  and  jugularis  extern. ;  upon  the 


THE  MUSCLES.  141 

muscles  of  the  hyoid  bone  and  larynx,  between,  upon,  behind 
and  external  to  the  Sterno-cleido-mastoidei.     We  distinguish: 

a.  Superficial  layer,  fixed  to  the  lig.  inter davicul.,  manubr. 
sterni. 

b.  Deep  Iny^r,  passing  away  behind  the  sterno-deido-mast.; 
it  forms  a  sheath  for  jugular,  inlerna  and  carotis   commun., 
enveloping  and  attaching  the  omo-hyoid  to  the  superior  border  of 
the  first  rib;  and  uniting  itself  with  the  fibro-cellular  tissue  upon 
the  scaleni  and  levator  scapulse,  which  is : 

9.11  c.  Fascise  prsevertebralis,  which  surrounds  the  longus 
colli  and  reef,  capitis.  antic,  major,  contains  below  much  fat 
and  fills  up  the  fossa  supraclavicularis .  It  attaches  itself  to  the 
superior  part  of  the  clavicle  as  far  forward  as  the  acromion,  and 
forms  a  boundary  between  t\\e  fossa  super  davicul.  and  the  cavity 
of  the  axilla;  behind,  it  embraces  the  cucullares  [Trapezius  m.]. 
Anteriorly  it  is  covered  by  Trachea,  pharynx,  and  oesophagus. 

III.  Muscles  of  the  Chest,  Regio  thoracica. 
9.1?..        1.  Pectoralis  major,  great  pectoral  muscle. 

Pos. :  beneath  the  skin  and  mammae,  on  the  anterior  surface  of 
the  thorax  and  before  the  axilla;  covering  the  subdavius  and 
pect.  minor.  Or.:  1.  Clavicula  (one-third  to  one-half  of  the 
anterior  border).  2.  Sternum.  3.  Cartilagines  Costar.,  2  to  7. 
Ins. :  Humerus  (spina  tubercul.  major) ;  between  biceps  (cap. 
breve)  and  triceps,  with  a  tendon  two  inches  broad,  under  that  of 
the  Deltoideus.  Use :  to  draw  the  arms  inwards,  so  that  they 
may  be  crossed  over  the  chest;  fixing  the  humeri,  to  draw  the 
ribs  outwards  and  expand  the  thoracic  cavity  (as  in  inspiration). 

213.  2.  Pectoralis  minor  (s.  serralus  anticus  minor). 

Pos. :  behind  the  last  muscle,  and  the  Nervi  and  Vasa  thorac.; 
its  superior  border  separated  from  the  Clavicula  by  a  triangular 
space,  behind  which,  Art.  axillaris,  separated  from  Pectoral, 
major  and  serratus  by  fat.  Or.:  Costa  III.  to  V.  (superior 
border  and  external  surface).  Ins. :  Proc.  coracoideus  (internal 
border  and  apex).  Use:  to  draw  the  shoulder  forwards,  inwards 
and  downwards ;  if  this  is  fixed,  to  elevate  the  third  to  the  fifth 
ribs  (m.  inspirator). 

Nerves :  (1 — 2)  thoradci,  intercostal.,  supradavicular. 

214.  3.   Subdavius  (costa-davicularis). 

Pos.:  along  the  inferior  surface  and  behind  the  Clavicula, 
above  the  Vasa  axillaria,  Plex.  brachial.  and  first  rib.  Or. : 


142  SPECIAL  ANATOMY. 

first  rib.  cartilage.  Ins. :  Clavicula  (the  external  end  of  the  in- 
ferior surface).  Use:  to  draw  the  acromial  end  of  the  clavicle 
downwards,  and  press  the  sternal  end  against  the  sternum,  on 
which  account  in  fracture  of  the  clavicle  the  outer  end  projects 
over  the  inner.  Elevates  also  the  first  rib  (m.  inspiratorius),  the 
Clavicula  being  fixed. 
Nerves:  pectoral  anterr. 

215.  4.   Serratus  anticus  major  (costo-scapularis). 

Pos. :  on  the  side  of  the  thorax,  covered,  above,  by  pectorales, 
below,  by  latissim.  dorsi  and  the  skin,  behind,  by  subscapularis. 
Or.:  Costae  1  to  8,  external  surface  (with  nine  or  ten  dentations). 
Ins.:  Basis  scapulse  (inner  lip),  above  and  below  very  thick; 
united  with  rhomboidei  and  subscapular.  by  strong  fibro-cellular 
tissue.  Use:  to  draw  the  scapula  forwards  and  outwards;  or 
the  first  to  the  eighth  ribs  upwards  and  inwards. 

Nerves :  thoracici,  intercostales. 

216.  5.  Intercostales  externi  and  interni. 

Pos.:  in  the  intercostal  spaces.  The  fibres  of  the  external 
pass  forwards  and  downwards,  those  of  the  internal  backwards 
and  downwards.  Or. :  the  inferior  border  of  each  rib.  Ins. : 
the  superior  border  of  the  following  inferior  rib.  Mm.  externi 
reach  from  the  neck  of  the  rib  to  the  cartilage.  Mm.  interni 
commence  at  the  angle,  terminate  at  the  sternum.  Use :  both  the 
same.  They  approximate  the  ribs,  either  upwards  in  fixing  the 
first  rib  (by  means  of  Mm.  scaleni)  inspiration  or  downwards 
in  fixing  the  twelfth  rib  (by  m.  quadratics  lumb.),  exspiratio. 

Nerves:  intercostales. 

217.  6.  Infracostales, 

variable  in  number  and  direction,  lying  on  the  internal  wall  of 
the  chest  between  ribs  and  diaphragm,  vertical  or  oblique  in 
shorter  or  longer  striae;  and  serving  to  assist  the  Mm.  inter- 
costales. 

218.  7.  Triangularis  sterni. 

Pos.:  behind  the  sternum,  before  the  diaphragm;  separated 
from  the  rib  cartilages  by  Vasa  mammaria.  Or. :  Corp.  sterni 
(the  external  border)  and  Proc.  ensiform.  Ins. :  Costse,  two  to 
five,  together  with  the  cartilages  (the  inferior  border).  Use:  to 
draw  the  second  to  the  fifth  ribs  downwards. 

Nerves:  intercostales. 


THE  MUSCLES.  143 

219.  Fasciae  perforates. 

1.  The  intercostal  muscles,  a  fascia  cover  externally,  which  is 
behind  the  continuations  of  the  Mm.  externi,  before  those  of  the 
interni;  in  the  thorax  they  are  separated  by  a  serous  layer  from 
the  diaphragm. 

2.  F.  coraco-clavicularis  (see  f.  Humeri)  invests  m.  sub  da- 
mns and  pectoralis  minor. 

3.  F.  superficial — the  m.  pectoralis  major,  and  the  inferior 
part  of  serratus  antic,  major. 

220.  IV.  Muscles  of  the  Neck  and  Back. 

We  may  distinguish  from  the  skin  of  the  back,  forwards,  five 
layers  of  muscles. 

A.  First  layer. 
Two  muscles. — Origins :  Proc.  spinosi. 

221.  1.   Cucullaris  s.  trapezius. 

Pos. :  on  the  neck  and  back :  meets  along  the  inner  border 
(proc.  spin.)  with  the  corresponding  muscle  of  the  other  side.  Its 
external  superior  border  bounds  the  interstit.  supra-clavicular e. 
Covers  above,  the  splenii,  in  the  centre,  the  Rhomboidei,  supra- 
spinatus  and  levator  scapul.,  then  a  portion  of  the  extensor  spinx 
and  latissim.  dorsi.  Or. :  1.  Proc.  spinosi  of  the  dorsal  vertebra 
and  Kg.  nuchse;  2.  Spina  occipital,  ext.  and  Lin.  semicirc. 
super,  (the  inner  third).  Ins.:  Spina  Scapulse,  Jlcromion,  Cla- 
vicula  (the  outer  third).  Fig. :  triangular,  the  base  turned  to- 
wards Proc.  spin. ;  both  together  quadrangular.  Use  :  to  draw 
the  shoulder  backwards  and  inwards  ;  the  superior  portion  draws 
it  upwards,  the  inferior  downwards. 

Nerves :  accessor.  Willis.,  cervical,  and  dorsalis. 

9.9.9.  2.  Latissimus  dorsi. 

Pos. :  below  in  the  lumbar  and  sacral  region ;  above  and  exter- 
nally behind  the  cavity  of  the  axilla.  Or.:  1.  From  external 
ramus  of  cristi  ilei,  tendinous.  2.  From  the  aponeur.  lumbo- 
dorsal.  between  crista  ilei  and  the  twelfth  dorsal  vetebra,  fleshy. 

3.  From  proc.  spinosi  of  the  sixteenth  to  the  nineteenth  vertebrae. 

4.  Fasciculi  from  the  ninth  to  the  twelfth  ribs. — All  the  fasciculi 
converge    towards    the    axillary   fossa.     Ins. :    Spina   tuberculi 
minor,  oss.  humeri  (2"  broad),  above  the  tendon  of  m.  pectoral, 
maj.;  behind  teres  major,  united  with  it.     Use:  to  draw  the 


144  SPECIAL  ANATOMY. 

shoulder  down,  rolling  the  arm  inwards  and  behind  (m.  aniscalp- 
tor) ;  draws  the  arm,  when  raised,  downwards,  or  the  trunk  to- 
wards it,  or  expands  the  thorax. 

Nerves :  dorsales,  lumbales,  and  sacrales. 

B.  Second  layer. 

223.  Seven  muscles  ;  some  covering  others. — Origin :  Proc. 
spinosi  (except  m.  levator  ariguli  scapulse).     Direction  of  fibres 
from  within,  outwards. 

224.  1.  Splenius  capitis. 

Pos. :  oblique  upwards  and  outwards,  covered  by  m.  cucullaris 
and  sterno-cleido-mast.  Above,  before  it:  trachelo-mastoid., 
complexus,  biventer  from  without,  inwards.  Or. :  Lig.  nuchx 
(third  to  the  sixth  vert.) ;  proc.  spin.  (vv.  seventh  to  the  eighth). 
Ins. :  Proc.  mastoideus  below  m.  sterno-cleido-mast. ;  and  be- 
low Linea  semicircular,  superior.  Use :  to  rotate  the  head,  so 
that  the  face  looks  towards  the  same  side;  both  acting  together 
draw  it  directly  backwards. 

225.  2.   Splenius  colli. 

Pos. :  close  to  the  outer  side  of  the  last  muscle ;  covered  by 
cucullar.  and  serrat.  post.  sup.  Or.:  Vv.  10  to  12  proc.  spin.; 
connected  with  the  last  muscle.  Ins. :  Vv.  first  to  third  proc. 
transv.  Use :  to  draw  the  neck  (also  atlas  and  head)  towards  its 
own  side ;  both  extend  the  neck. 

226.  3.  Levator  anguli  scapulas. 

Pos. :  outside  the  last ;  above,  covered  by  sterno-cleido'm,ast. 
besides  by  trapezius.  Or. :  Vv.  1  to  4  proc.  transv.  (3  to  4 
heads)  external  to  the  splenius  colli,  behind  the  scalen.  post. 
Ins. :  Scapulas  angulus  superior  (between  rhomboidei  and  serrat. 
magn).  Use  :  to  elevate  the  internal  superior  angle  of  the  scapula 
(to  shrug  the  shoulders). 

227.  4.  Rhomboideus  superior  s.  minor. 

Pos. :  transverse  between  vertebras  and  scapula. 

Or. :  Vv.  6  to  7  proc.  spinosi  (lig.  nuchse}.  Ins. :  Bas.  sea- 
pulse  labium  externum  (the  superior  part).  Use :  to  draw  the 
scapula  inwards  and  upwards. 

228.  5.  Rhomboideus  inferior  s.  major. 

Pos. :  below  the  last  m.  in  a  similar  direction.  Or. :  Vv.  11 
to  13  proc.  spinosi.  Ins.:  Bas.  scapulas  lab.  extern,  (the  infe- 


THE  MUSCLES.  145 

rior  part).     Use:  to  draw  the  scapula  (particularly  the  inf.  angle) 
inwards,  whereby  the  shoulder  (humeral  end)  sinks. 

229.  6.   Serratus posticus  superior. 

Pos. :  covered  by  the  two  preceding  muscles,  meeting  anteriorly 
in  the  m.  scalen.  post.  Or.:  Vv.  seventh  to  the  tenth  proc. 
spinos.  Ins. :  Costae  second  to  the  fifth  (superior  border,  in  the 
neighbourhood  of  the  angulus).  Use  :  to  draw  the  second  to  the 
fifth  rib  upwards  (m.  inspirat.). 

230.  7.   Serratus  posticus  inferior. 

Pos. :  in  the  lumbar  region,  anterior  to  the  m.  latissim.  dorsi, 
united  with  its  tendon.  Or. :  Vv.  eighteenth  to  the  twenty-second 
proc.  spinos.  Ins.:  Costx  ninth  to  the  twelfth  (the  inferior 
border).  Use:  to  draw  the  ninth  to  the  twelfth  ribs  backwards 
and  downwards,  and  to  fix  them. 

Nerves :  (first  to  the  seventh)  rr.  posterr.  nn,  spinalium. 

231.  C.  Third  layer. 

Pos. :  in  the  posterior  fossa  of  the  vertebral  column,  between 
proc.  spinosi  and  transversi,  or  anguli  costarum,  separated  from 
the  layers  1  and  2  by  fasc.  lumbo-dorsal.  Or. :  Proc.  transversi. 

232.  1.  Biventer  cervicis. 

Pos. :  covered  above  by  diaphragm,  below  by  splenii  and 
serrat.  sup.;  lies  upon  semi-spinal  cervic.  and  complezus.  Or.: 
Vv.  ninth  to  the  fourteenth  proc.  transvers.  (Apex).  Ins.:  Linea 
semicircular,  superior,  (in  the  centre),  united  with  m.  complex, 
cervic. — The  tendon  between  separates  the  superior  and  inferior 
belly.  Use :  to  draw  the  head  backwards  and  rotate  it  a  little ; 
both  extend  it. 

233.  2.  Complexus  cervicis. 

Pos. :  outside,  close  to  the  last  m.,  covered  by  it,  the  splenii 
and  trachelo-mast.  Or. :  1.  Vv.  eighth  to  the  tenth  proc.  transv. 
2.  Vv.  third  to  the  seventh  proc.  obliqui.  Ins. :  below  linea  semi- 
circular, superior,  between  trachelom.  and  the  central  line.  Use: 
to  draw  the  head  backwards  and  rotate  it  more  strongly  than  the 
last. 

234.  3.   Trachelo-mastoideus. 

Pos.:  external  to  the  last,  and  before  it;  below  covered  by 
splenii  and  lev.  scapulae.  Or. :  1  Vv.  seventh  to  the  eleventh 
proc.  transv.  2.  Vv.  fourth  to  the  sixth  proc.  obliq.  with  seven 
fasciculi.  Ins.  :  Proc.  Mastoid.  (posterior  part).  Use :  to  draw 
the  head  backwards  and  sideways. 
10 


146  SPECIAL  ANATOMY. 


235.  4.   Transversalis  cervicis. 

Pos.:  external  to  and  (above)  before  the  last;  united  below 
with  m.  longissimus  dorsi.  Or. :  Vv.  eighth  to  the  fourteenth 
proc.  transv.  Vv.  fourth  to  the  seventh  proc.  obliq.,  with  seven 
fasciculi.  Ins. :  Vv.  second  to  the  sixth  proc.  transv.  Use  :  to 
incline  the  neck  sideways. 

236.  5.  Cervicalis  descendens. 

Pos. :  lateral  in  the  neck,  before  the  last  muscle,  and  behind 
muse,  scalen.  post.  Or. :  Vv.  fourth  to  the  sixth  proc.  transv. 
Ins. :  costse  third  to  the  sixth  (the  superior  border,  opposite  the 
angle).  Use:  to  draw  the  neck  sideways;  or  raise  the  third  to 
the  sixth  ribs. 

Nerves :  rr.  posterr.  nn.  cervicall.  (from  the  first  to  the  fifth). 

237.  6.  Longissimus  dorsi. 

Fig. :  three-sided,  below  thick.  Pos.:  external  to  spinal,  dorsi, 
internal  to  ilio-costalis,  behind  multifid.,  semispinalis,  levator. 
costar.,  covered  byfasc.  ilio-dorsal  and  serrati  postici,  along  the 
vertebral  column,  the  neck  excepted.  Or. :  tendinous  from  proc. 
spin,  of  Sacrum  and  the  three  inferior  lumbar  vertebrae,  fleshy 
from  the  posterior  part  of  fossa  ovalis  oss.  ilei.  Ins.:  a.  internal 
fasciculi  to  the  lumbar  vertebrae  and  proc.  transv.  of  all  the  dor- 
sal; b.  external  fasciculi  to  the  proc.  transv.  of  all  the  lumbar 
vertebrae  and  to  the  twelfth  to  the  second  ribs  (the  lower  border). 
Use :  to  extend  the  lumbar  and  dorsal  portions  of  the  vertebral 
column,  drawing  the  chest  downwards. 

238.  7.  Ilio-costalis  (s.  sacro-lumbalis). 

Fig. :  long.  Pos. :  upon  the  longiss.  dors,  external  to  it,  on 
the  lumbar  vertebrae  and  behind  the  ribs,  ascending  internally  to 
angul.  cost.;  covered  posteriorly  byfasc.  lumbo-dorsal.  and 
serrati  postic.  Or.:  a.  labium  extern,  crist.  ilei;  b.  from  the 
origin  of  longiss.  dorsi  on  the  third  to  fifth  lumbar  vertebrae ;  c. 
from  the  sixth  to  the  seventh  inferior  ribs  (superior  border).  Ins. : 
first  to  twelfth  ribs  (inf.  border  of  angle).  Use :  to  draw  the  ribs 
downwards.  The  continuation  forms  cervical,  descendens.  [The 
origins,  c,  pass,  also,  under  the  name  of  musculi  accessorii  ad 
sacro-lumbalem.~] 

Nerves :  (sixth  to  the  seventh)  rr.  postt.  nn.  intercostt.  and  lumball. 

D.  Fourth  layer. 
Origins  :  proc.  spinos.  or  transv.     Ins. :  proc.  spinosi. 


THE  MUSCLES.  147 

239.  1.  Spinalis  dor  si. 

Pos.  :  between  proc.  spin,  and  longiss.  dor  si ;  upon  multi- 
fidus,  covered  by  serrati  post.  Or. :  Vv.  seventeenth  to  the 
twenty-first  proc.  spin.  Ins. :  Vv.  fifteenth  to  the  ninth  proc. 
spinos.  Use  :  to  extend  the  back. 

240.  2.  Spinalis  cervicis. 

Pos. :  in  the  neck,  close  to  proc.  spin.  Or. :  Vv.  eighth  to 
the  ninth  proc.  spin.  Ins. :  Vv.  third  to  the  second  proc.  spin. 
Use  :  to  extend  the  neck. 

241.  3.   Semispinalis  dorsi. 

Pos.  before  m.  longissim. ;  behind  multifid.;  below  and  in- 
ternal: spinal,  dorsi;  above  and  external:  semispinal.  and  bi- 
venter  cervicis.  Or. :  Vv.  thirteenth  to  the  eighteenth  proc.  trans. 
Ins. :  Vv.  tenth  to  the  fifth  proc.  spin.  Use:  to  draw  the  back 
obliquely  backwards. 

242.  4.   Semispinalis  cervicis  (s.  colli). 

Pos.:  before  m.  biventer,  behind  multifidus.  Or.:  Vv.  eighth 
to  twelfth  proc.  transv.  Ins. :  Vv.  fifth  to  the  second  proc.  spin. 
Use :  to  draw  the  neck  obliquely  downwards  and  backwards. 

243.  5.  Levatores  costarum  s.  supracostales. 

a.  breves,  twelve. 

Pos. :  before  m.  longiss.  dors,  and  ilio-costal.,  and  cervic.  de- 
scend., behind  the  diaphragm  in  the  post,  part  of  the  intercostal 
spaces.  Or. :  Vv.  seventh  to  the  eighteenth  proc.  transv.  Ins. : 
Costse,  first  to  the  twelfth  (the  superior  border  of  the  posterior 
part).  Use  :  to  draw  the  ribs  backwards  and  upwards. 

b.  longi,  four. 

Or. :  Seventh  to  the  tenth  proc.  transv.  Ins. :  ninth  to  the 
twelfth  ribs. 

Nerves:  rr. postt.  nn.  cervical!,  and  dorsatt.  (from  first  to  the  fifth). 

E.  Fifth  layer, 

close  upon  the  vertebral  column  in  the  spaces  between  the  pro- 
cesses.    Small  muscles. 

244.  1.  Rectus  capitis  post,  major. 

Pos. :  before  complexus  upon  the  post,  arch  of  the  Mas.  Or. : 
Proc.  spin,  epistroph.  (dentatus).  Ins.:  Linea  semicircular, 
infer.  1"  broad,  near  the  middle  line.  Use :  to  extend  the  head. 


148  SPECIAL  ANATOMY. 

245.  2.  Rectus  capitis  posticus  minor. 

Pos. :  internal  and  close  to  the  last,  before  and  covered  by  it. 
Or. :  Atlas  (tuberc.  post.).  Ins. :  Linea  semicircular,  inferior. 
[In  the  fossa  below  this.]  Use  :  to  extend  the  head. 

246.  3.    Obliquus  capitis  superior  s.  minor. 

Pos. :  external  and  close  to  the  last  muscles,  oblique.  Or. : 
Atlas  (proc.  transv.).  Ins. :  Os  occiput  (between  the  lin.  semic. 
infer,  and  superior,)  behind  proc.  mastoid.  Use :  to  draw  the 
head  backwards,  or  rotate  it  towards  the  opposite  side. 

247.  4.   Obliquus  capitis  inferior  s.  major. 

Pos. :  oblique,  outwards  and  upwards,  covered  by  complex. 
and  trachelo-mast.  Or.  :  Epistropheus  (on  the  side  of  proc. 
spinos.).  Ins.:  Atlas  (proc.  transv.).  Use:  to  rotate  the  Atlas 
(with  the  head  and  face)  towards  its  own  side. 

248.  5.  Multifidus  spines. 

Pos. :  between  the  spinous  and  transverse  processes  of  the 
entire  vertebral  column ;  immediately  upon  the  vertebrae  (and  ro- 
tatores  dorsi;  covered  by  longiss.,  spinalis  dorsi,  semispin.  dorsi 
and  cervicis,  complexus.  Or.:  Lateral  parts  of  the  Sacrum; 
proc.  transv.  (inferior  vertebras)  and  obliqui  (in  the  neck).  Ins. : 
proc.  spinosi  (superior  vert.).  Use  :  the  separate  fasciculi  rotate 
the  vertebras ;  the  entire  muscle  extends  the  column. 

249.  6.  Inter spinal es. 

In  the  spaces  between  the  Proc.  spinosi,  of  the  cervical  (second 
to  the  seventh)  and  lumbar  vertebrae.  Use:  to  extend  the  verte- 
bral column. 

250.  7.  Intertransversales. 

In  the  spaces  between  Proc.  transversi  ;  in  the  neck :  externi 
and  interni  (generally  wanting  in  the  back).  Use  :  to  draw  the 
vertebras,  and  consequently  the  column,  sideways. 

251.  8.  Rotator  es  dorsi. 

Pos. :  covered  by  multifidus  spinse,  on  the  dorsal  vertebras, 
transverse.  Or. :  proc.  transversi  (superior  border).  Ins. :  Arch 
of  the  vert,  next  above. 

Nerves:  rr. posterr.  nn.  tpinalium  (from  the  first  to  the  eighth). 


THE  MUSCLES.  149 

Fasciae. 

252.  1.  Fascia  nuchae,  between  the  first  and  second  layer  of 
cervical  muscles,  blends  before  with   the    cucullar.  in  the  fasc. 
cervical.,  behind  in  the  lig  nuchae.     2.  F.  lumbo-dorsalis.     a. 
Superficial  posterior  layer,  connected  above  with  the  last  men- 
tioned, descends  from  the  spinous  process  of  the  tenth  vertebrae 
to  the  last  Sacral,  attaching  itself  externally  and  below  to  the 
Crista  Ilei,  externally  and  above  to  the  angul.  post,  scapulae;  is 
covered  above  by  Mm.  cucullaris,  rhomboideus  and  latissim. 
dorsi,  below  only  by  the   skin   of  the  back.     b.  Deep,  anterior 
layer,  between  the  twelfth  rib  and  cristailei,  forms  between  Proc. 
transv.  vertebrae  lumbalis  and  the  twelfth  rib  a  tendinous  cres- 
centic  margin,  and  with  the  superficial  layer  a  triangular  sheath 
for  the  third  and  fourth  layers  of  muscles. 

V.  Abdominal  Muscles,  Mm.  abdominales. 

253.  1.  Obliquus  abdominis  externus  s.  descendens. 

Pos.  in  front  and  on  the  side  of  the  abdomen,  close  behind  the 
skin,  broad  and  four-sided,  oblique  ;  before  the  following  muscles, 
the  anterior  portion  of  the  seventh  and  eighth  last  ribs;  covered 
on  the  posterior  border  by  latissim.  dorsi.  Or.:  Fifth  to  the 
twelfth  ribs  (with  seven  to  eight  attachments  forming  dentations 
with  M.  Serratus  magnus)  2  to  3"  broad  from  the  inferior  border, 
fleshy.  Ins.:  1.  the  crest  of  the  Ilium  (lab.  extern.);  2.  the 
linea  alba,  with  a  wide  aponeurosis.  Direction  of  the  fibres  from 
above  downwards  and  from  behind  forwards.  Use:  1.  contracts 
the  abdominal  cavity ;  2.  draws  the  ribs  downwards,  and  thereby 
flexes  the  thorax;  or,  3.  if  this  is  fixed,  the  pelvis  (m.  exspira- 
torius). 

254.  2.  Obliquus  abdominis  internus  s.  ascendens. 

Pos. :  behind  the  last  m.  covering  the  following ;  before  broader 
than  behind,  where  it  reaches  to  the  spinous  processes  ;  the  fleshy 
part  at  the  side  of  the  abdomen.  Or. :  fleshy  from  the  anterior 
third  of  the  crista  ilei  and  lig.  Poupartii.  Ins. :  Tenth  to  the 
twelfth  rib  cartilages  (the  inferior  border) ;  and  internally,  Linea 
alba,  with  a  broad  tendon.  Use:  the  same  as  the  preceding 
muscle. 

255.  3.   Transversus  abdominis. 

Pos. :  transverse  around  the  abdomen,  from  proc.  msiform.  as 
ar  as  symphysis  pubis,  on  the  lumbar  vertebras  between  ilio- 
costal.  and  quadrat,  lumborum,  separated  from  the  diaphragm 
behind  it  by  fascia  trans versalis.  The  fibres  pass  directly  from 


150  SPECIAL  ANATOMY. 

within  outwards,  connected  above  with  the  diaphragm  and  tri- 
angularis  sterni.  Or.:  1.  Cartil.  costae,  seventh  to  the  twelfth 
(the  internal  surface) ;  2.  Crista  ilei  labium  internum  (two-thirds) 
and  Lig.  Poupartii;  3.  Proc.  transversi  of  the  lumbar  vert. 
Ins. ;  fleshy  above  to  proc.  ensiform.,  tendinous  to  linea  alba. 
Use :  to  contract  the  abdominal  cavity  (in  defecation  and  expira- 
tion) stronger  than  the  two  preceding  muscles. 

256.  rfrcus  cruralis,  s.  ligamentum  Poupartii,  s.  Fallopise. 
The  inferior  sharp  border,  reflected  backwards,  of  the  tendon 

of  obliq.  extern.,  which  passes  obliquely  from  without  and  above, 
inwards  and  downwards  between  Spina  ilei  ant.  sup.  and  sym- 
physis  pubis,  for  two  inches  in  width  from  Spina  Ilei,  firmly 
attached  to  the.  fasc.  iliaca,  and  extended  like  a  pillar,  bounds 
anteriorly  a  triangular  space,  the  posterior  limit  of  which  is  formed 
by  the  os  ilei  and  pubis.  This  space  is  filled  up — commencing 
on  the  outside,  with":  M.  Psoas  and  iliacus,  Nerv.,  Art.  Fen., 
cruralis,  m.  pectineus. 

The  fascia  femoris  is  attached  to  the  inferior  sharp  border;  the 
free  border  of  the  reflected  portion  is  firmly  connected  externally 
to  the  fascia  iliaca,  internally  to  the  fasc.  transv.  Between  the 
two  borders  lies  a  channel  above  concave,  which  is  the  floor  of 
the  Canal,  inguinalis.  It  first  commences  on  the  internal  border 
of  77i.  psoas.  Before  the  attachment  to  the  Symphysis  pubis, 
the  lig.  Poupart.  divides  into  two  crura  or  pillars,  between  which 
the  triangular  abdominal  ring  (annulus  abdominalis)  serves  as  an 
entrance  into  the  inguinal  canal.  The  superior,  internal  pillar, 
crus  internum,  broader  and  longer,  passes  away  over  the  Sym- 
physis pubis  by  the  Spina,  and  then  decussates  with  similar 
fibres  from  the  other  side.  The  inferior  pillar,  crus  externum, 
is  roundish,  attaches  itself  to  Spina  pubis  of  its  own  side,  and  is 
connected  with  the  crista pubis  by  means  of: 

257.  Lig.    Gimbernati,  a   triangular,   horizontal,  tendinous 
band  (about  half  an  inch  long),  the   external,  concave,  almost 
sharp  border  of  which  forms  the  internal  boundary  of  the  annu- 
lus cruralis.     From  its  superior  surface  a  tendinous  band  passes 
to  the  fascia  femoris. 

258.  JLnnulus  abdominalis  and  inguinalis  externus,  abdomi- 
nal, external  inguinal  ring,  between  the  crura  of  Lig.  Poupartii 
on  the    Symphysis  pubis,  oval  or  triangular,  the  apex  directed 
upwards   and  outwards,  covered  anteriorly  by  the  delicate  fasc. 
superficialis  [fascia  spermatica  extern.^,  formed  behind  of  fibres 
from  obliq.  intern,  transversalis,  and  fasc.  transv.,  is  the  ex- 
ternal opening  of: 

259.  Canalis  inguinalis  (for  the  spermatic  cord  of  the  male, 


THE  MUSCLES.  151 

the  round  ligament  in  the  female),  which  perforates  the  anterior 
abdominal  parietes  formed  of  the  three  preceding  muscles,  is  lj 
to  2"  long,  and  passes  in  the  direction  of  lig.  Poupartii,  obliquely 
from  above,  outwards  and  backwards,  downwards,  inwards  and 
forwards.  M.  obliq.  extern,  forms  its  inferior  and  anterior  wall, 
its  posterior  the  fasc.  transv.  and  tendinous  fibres  of  obliq.  intern. 
and  transv.  (towards  the  annul,  abdominal.) ;  its  superior,  the 
inferior  borders  of  mm.  obliq.  intern,  and  transv.  The  interior 
of  the  canal  is  lined  by  fasc.  trans,  [fasc.  spermatica  intern^], 
which  continues  down  into  the  scrotum  as  a  common  envelope  of 
the  spermatic  cord  and  testicle.  Behind  it  opens  into  the  abdo- 
minal cavity  by  means  of  the  irregular 

260.  Jinnwut  inguinalis  internus  (at  a  distance  of  2"  from 
the  spina  ilei  sup.),  on  the  internal  semilimar  sharp  border  of 
which  (plica  semilunaris  of  the  fasc.  transv.)  the  Art.  epigas- 
trica  passes  upwards  and  inwards.     Through  this  ring,  in  the 
mature  foetus,  the  testicle,  together  with  the  spermatic  cord,  passes 
out  from  the  abdominal  cavity  into  the  inguinal  canal,  and  thence, 
into    the   scrotum.     At   birth  the  annul,  inguinal,  intern,  and 
extern,  lie  close  behind  one  another. 

261.  Linea  alba  is  the  white  stripe  found  in  the  central  line  of 
the   abdominal  parietes,  in  which  the  aponeuroses  of  the  lateral 
abdominal  muscles  are  associated  together  (or  decussate,  Velpeau), 
which  passes  downwards  from  Proc.  ensiform.  as  far  as  Symph. 
pubis,  between  the  mm.  recti,  above  the  umbilicus  3  to  2'",  at  it 
£",  below  it  1'"  broad.     The  navel  ring,  annulus  umbilicalis,  is 
a  large  (rhombic,  Velpeau)  opening  in  about  [below]  the  centre, 
through  which  in  the  (new-born)  infant  the  umbilical  vessels  (fre- 
quently also  portions  of  intestine)  pass.     On  the  anterior  surface 
the  white  line  is  stretched  by  the  m.  pyramidalis;  on  the  pos- 
terior surface  it  is  strengthened  by  the  lig.  triangulare  s.  admini-' 
culum  lin.  albas,  the  apex  upwards. 

Nerves:  (first  to  the  third)  intercostaks,  lumbaks,  iliohypogastricus. 

262.  4.  Rectus  abdominis. 

Pos. :  close  to  [the  outer  side  of]  the  linea  alba  [on  the  inside 
of  linea  semilunaris,  a  curved  tendinous  line,  extending  from  the 
cartilage  of  the  eighth  rib  to  the  tuberosity  of  the  os  pubis],  in 
the  very  strong  vagina  recto-abdominalis.  Fig. :  elongated,  flat, 
with  two  to  six  tendinous  transverse  striaB,  inscriptiones  tendinse. 
Or. :  Symph.  oss.  pubis  (with  two  tendons).  Ins. :  fifth  to  seventh 
rib  cartilages  (anterior  surfaces),  Proc.  ensiformis.  Use :  to 
compress  the  abdominal  viscera ;  to  draw  the  sternum  and  the 
fifth  to  seventh  ribs  downwards  (exspiratio),  or,  to  flex  the  pelvis. 


152  SPECIAL  ANATOMY. 

263.  5.  Pyramidalis  abdominis. 

Pos. :  before  the  inferior  extremity  of  the  preceding  muscle, 
close  to  the  linea  alba,  covered  by  the  anterior  layer  of  its  sheath. 
Or. :  Symphys.  pubis  (the  superior  border) ;  broad.  Ins. :  Linea 
alba, between  umbilicus  andsymphysis;  pointed.  Use:  to  stretch 
linea  alba. 

Nerves :  (fourth  to  fifth)  iliohypogastricus. 

264.  6.  Cremaster  s.  tunica  erythroides. 

Pos. :  in  front  and  on  the  side  of  the  spermatic  cord  (in  the 
canal  inguinalis) ;  thin,  long.  Or. :  Spina  pubis  and  M.  obliq. 
intern.  Ins.:  Tunica  vaginal,  commun.funical.  sperm,  et  tes- 
ticuli.  Use  :  to  draw  the  testicle  upwards,  pressing  the  spermatic 
cord. 

265.  7.   Quadratus  lumborum. 

Pos. :  along  the  lumbar  vertebrae,  in  a  strong  tendinous  sheath, 
behind  the  kidneys,  the  colon,  psoas  and  diaphragm  muscles  ; 
between  the  Ilium  and  last  rib ;  covered  behind  by  the  tendon 
of  trans  versalis.  Or.:  1.  Crista  ilei  labium  intern,  (the  posterior 
part);  2"  broad;  2.  Lig.  ileo-lumbale;  3.  Proc.  transv.  of  the 
lumbar  vertebrae.  Ins. :  twelfth  rib — the  inferior  border  of  the 
posterior  extremity.  Use :  to  draw  the  twelfth  rib  downwards 
(exspiratio) ;  inclining  the  vertebral  column  sideways,  or  the 
pelvis. 

Nerves:  lumbaks. 

266.  8.  Diaphragma. 

This  is  the  transverse,  muscular,  dome-shaped,  vaulted  partition 
which  separates  the  thoracic  from  the  ventral  cavity.  It  is  ten- 
dinous in  the  centre  (pars  tendinea),  fleshy  in  the  periphery  (p. 
carnosa),  which  is  attached  to  the  ribs  (p.  costal.)  and  to  the 
lumbar  vertebrae  (p.  lumbal.). 

Attachments :  a.  the  bodies  of  the  second  to  the  fourth  lumbar 
vertebrae  (anterior  surface). 

b.  Sternum  and  Proc.  ensiform.;  cartilage  of  the  seventh  to 
the  twelfth  ribs  (posterior  surface). 

a.  Pars  lumbalis  consists  of  six  (three  on  each  side)  crura. 

a.  Crura  internet,  strong,  arise  from  the  third  to  the  fourth  lumbar  vertebrae ; 
between  them  lies: 

act.  Hiatus  aorticus  (for  aorta,  ductus  thoracicus,  vena  azygos),  3"  long,  \" 
broad,  rather  to  the  left  of  the  central  line. 

The  internal  crura  cross  each  other  before  the  parts  above  mentioned,  and 
in  this  way  form  the 

&B.  Foramen  ccsophageum  for  the  (oesophagus,  nn.  vagi,  and  continuation  of 


THE  MUSCLES.  153 

the  pleura),  2"  long,  3  to  4"'  broad.  The  crura  then  pass  into  the  tendinous 
centre. 

B.  Crura  Media  arising  from  the  sides  of  the  second  lumbar  vertebra,  or 
from  lig.  intervertebrale,  uniting  above  with  the  internal  and  external  crura, 
passing  into  the  centr.  tendin.  become  perforated  by  N.  splanchnicus  minor. 
Between  the  central  and  internal  crura  pass  through :  Nn.  splanchnid  maj.  • 
between  the  central  and  external:  Nn.  sympatkici,  Vena  hemiazygos  upon  the 
left  and  Vena  azygos  sometimes  upon  the  right  side. 

•y.  Crura  externa,  very  short,  arise  from  the  first  lumbar  vert,  (side  of  the 
body) ;  are  united  with  lig.  vertebro-costale  before  m.  psoas,  and  quadrat,  lumb^ 
losing  themselves  in  the  Centr.  tendineum. 

b.  Pars  costalis   (and  sternalis),  see  under  "Attachments." 
Upon  either  side  six  fleshy  heads  from  the  rib  cartilages  and  two 
from  the  Proc.  ensiformis  pass  inwards  towards  the  Cent,  ten- 
dineum, which  on  the  four  inferior  ribs  are  connected  with  m. 
transv.  abdom.     Quite  in  front  is  found  a  small  triangular  inter- 
space in  which  the  Pleura  and  Peritonaeum  come  in  contact. 

c.  Centrum  tendineum  s.  speculum  Helmontii,  the  central  ten- 
dinous portion,  in  shape  like  a  trefoil  leaf,  is  the  most  elevated 
portion  of  the  diaphragm,  on  a  level  with  the  fifth  rib  (at  the 
sternum),  on  the  right  side  (over  the  liver)  arched.     In  it,  to  the 
right  of  the  central  line,  we  find  the/oram.  quadriloterum  (I  to 
l£"  diam.),  through  which  aperture  the  V.  cava  inferior  ascends 
from  the  liver  to  the  right  ventricle  of  the  heart,  and  the  pleura 
and  peritonaeum  come  in  contact. 

The  superior  (thoracic)  surface,  which  in  the  fo3tus  is  much 
more  vaulted  than  after  birth,  when  the  lungs  have  fairly  respired, 
is  covered  by  Pleura  and  Pericardium,  and  serves  for  the  support 
of  the  lungs  and  heart. 

The  inferior  surface  is  covered  by  peritonaeum,  except  at  the 
point  corresponding  to  the  obtuse  border  of  the  liver  (lig.  coronar. 
hepat.}.  On  the  right  lies  the  liver,  left  the  spleen  and  fundus  of 
the  stomach. 

Use:  the  diaphragm,  as  it  contracts,  widens  the  thoracic  and 
diminishes  the  abdominal  cavity.  Thus  in  inspiration  and  in  the 
evacuation  of  the  contents  of  the  intestines. 

Nerves :  phrenicus,  branches  of  Vagus,  lumbal^  intercostal^  sympathicus. 

Fasciae  Jlbdominales. 

267.  1.  Fascia  superficialis  abdominis  covers  the  anterior 
surface  of  the  abdominal  muscles,  is  thin  upon  the  fleshy  parts, 
firmly  attached  and  thick  upon  the  tendinous,  particularly  below 
the  navel,  consists  of  fibre-cellular  tissue  interwoven  with  tendi- 
nous and  elastic  fibres ;  passing  before  the  annul,  abdomin.  over 
the  spermatic  cord  into  the  Scrotum,  it  goes  to  join  the  fasc. 
femor.  superficialis. 


154  SPECIAL  ANATOMY. 

268.  2.  Fasc.  transv.  abdominis  mounts  upwards  from  lig. 
Poupartii  between  the  abdominal  muscles  and  peritonaeum;  is 
below,  particularly  at  the  lig.  Gimbernati,  the  strongest  where  a 
posterior  layer  (from  the  spina  pubis  as  far  as  the  internal  bound- 
ary of  the  internal  inguinal  ring)  ascends  almost  vertically,  whilst 
an  anterior  layer  passes  obliquely  outwards  and  upwards,  and 
forms  the  external  boundary  of  the  internal  inguinal  ring.     (On 
account  of  the  strength  of  this  fascia  internal  [direct]  inguinal 
herniae  are  rare.) 

269.  3.    Vagina  m.  recti,  passes  outwards  from    the  linea 
alba,  encloses  both  recti  abdom.,  splits  at  their  external  border, 
receives  between  the  divisions  the  mm,,  obliq.  extern.,  intern., 
:md  transv.,  and  passes  over  intofasc.  transv ersalis.     The  pos- 
terior layer  above  (before  the  rib  cartilages)  and  below  becomes 
somewhat  separated,  and  terminates  in  the-  centre  between  the 
navel  and  symphysis,  with  a  border  concave  below,  linea  semi- 
circular. Douglasii. 

VI.  Muscles  of  Anus  and  Perineum. 
Mm.  ano-perinseales. 

270.  1.   Sphincter  ani  (externus  et  internus}. 

Pos. :  oval,  round  about  the  inferior  extremity  of  the  rectum ; 
about  one  inch  high.  Sphincter  ani  internus  is  nothing  but  the 
last  (white)  circle  of  the  muscular  fibres  of  the  rectum.  Or. : 
1.  The  lowest  circle,  that  is  externus  before  the  coccyx  from  the 
fibro-cellular  tissue  beneath  the  skin;  2.  The  superior  circle  from 
the  fibrous  membrane  at  the  apex  of  the  coccyx.  Ins.:  1.  In 
the  subcutaneous  fibro-cellular  tissue,  pointed.  2.  The  fibrous 
raphe  on  the  anterior  boundary  of  the  rectum.  Use :  closes  the 
anus,  and  assists  the  urethra,  compressing  it  behind. 

271.  2.  Transversus  perin&i  (superjicialis  et  profundus). 
Pos. :  nearly  transverse  before  the  anus,  close  above  the  skin, 

behind  levator  ani;  forms  the  posterior  border  of  a  triangle  the 
external  border  of  which  is  m.  ischio-,  the  internal  bulbo-cavern- 
osus.  It  covers  the  bulbus  urethra  above.  Perin.  superfic.  is 
the  posterior;  profundus  the  anterior  portion.  Or.:  tuber  Ischii 
(internal  surface — close  below  iscliio-cavernosus}.  Ins.:  tuber 
Ischii,  the  other  side  connected  with  sphincter  ani  and  bulbo- 
cavernosus.  Use:  presses  the  anterior  wall  of  the  rectum  to- 
wards the  posterior,  as  in  defaecation. 

272.  3.  Coccygeus  s.  ischio-coccygeus. 

Pos. :  flat,  triangular  at  the  inferior  extremity  of  the  pelvis ; 
covered  by  M.  glutseus  max.  at  the  post,  border  of  the  m.  leva- 


THE  MUSCLES.  155 

tor  am,  with  which  it  forms  the  floor  of  the  pelvis.  Or. :  ten- 
dinous from  Spina  Ischii  and  lig.  spinos  o-sacrum.  Ins. :  Os 
coccygis  (border  and  anterior  surface),  Os  sacrum  (apex).  Use: 
assists  in  bending  the  coccyx  forwards ;  both  acting  together  fix 
it  (in  ejection  of  the  semen). 

273.  4.  Curvator  coccygis. 

Pos. :  upon  the  anterior  surface  of  the  coccyx,  mostly  tendi- 
nous. Or. :  from  the  sides  of  the  apex  of  the  os  sacrum.  Ins.: 
apex  of  coccyx.  Use  :  to  bend  the  coccyx. 

274.  5.  Extensor  coccygis. 

Pos. :  upon  the  posterior  surface  of  the  coccyx,  mostly  tendi- 
nous. Or. :  from  the  apex  of  os  sacrum  spin,  ilei  poster,  infer. 
Use  :  to  draw  the  coccyx  backwards. 

275.  6.  Lev  at  or  Jlni. 

Pos. :  before  the  preceding  muscle,  anteriorly  narrow,  behind 
broad  ;  four-sided ;  covered  by  fascia  pelvis  ;  below,  by  sphincter 
anij  and  behind  by  M.  glutseus  max. ;  before,  by  M.  obturator 
intern.  Between  the  anterior  borders  of  the  two  decussating 
muscles  and  the  pubic  arch  a  longitudinal  fissure  remains,  through 
which  the  urinary  and  genital  organs  pass  out.  Or. :  1.  ramus 
descend,  pubis  (internal  surface),  as  far  as,  2.  Spina  Ischii. 
Ins.:  1.  the  sides  of  the  Prostata,  urinary  bladder,  and  the 
Rectum.  2.  the  apex  of  the  coccyx  as  far  as  sphincter  ani.  M. 
pub  o-urethr  alis,  a  thin  fasciculus  which  passes  to  the  urethra. 
Use :  draws  the  anus  backwards  and  upwards,  expands  it  (in  the 
act  of  defecation),  likewise  the  coccyx,  contracting  the  pelvic 
outlet.  [Or. :  from  a  fibrous  cord  extending  from  the  body  of 
the  Pubis  to  the  spine  of  the  Ischium.~] 

276.  7.  Ischio-cavernosus,  s.  erector  penis,  s.  clitoridis. 
Pos.:  close  to  the  ram.  ascendens  oss.  ischii;  covered  below 

by  fibro-cellular  tissue,  above  by  corp.  cavernosum;  internally 
lies  M.  bulbo-cavernosus,  separated  from  it  by  a  triangular  space. 
Or. :  tuber  ischii  and  ram.  ascendens.  Ins. :  Corp.  cavernosum 
penis;  to  the  entire  length  of  the  Crus.  Use:  presses  the  root 
of  the  Penis  against  the  bones,  maintaining  the  already  erect  organ 
in  a  direction  forwards  ;  does  not  compress,  but  widens  the  root 
of  Corp.  cavernosum  penis. 

277.  8.  Bulbo-cavernosus  s.  accelerator  urinx  [s.  ejaculator 

seminis']. 
Pos. :  before   the  anus,  below  and  along  the  bulbus   and  the 


156  SPECIAL  ANATOMY. 

portio  spongiosa  of  the  urethra,  which  it  surrounds  like  a  kind 
of  sheath,  below  covered  by  the  skin  of  the  perinaeum.  The  in- 
ternal borders  of  the  two  muscles  meet  together.  Or. :  lig.  perin. 
triangular.,  sides  of  bulbus  and  cor/?,  cavern,  urethrse,  and  penis. 
Ins.:  Corp.  cavernosum  urethras;  pubo-cavernosus  s.  levator 
penis,  anterior  portion  of  bulbo-cavernosus  ;  sometimes  appears, 
isolated,  between  the  lig.  suspensor  penis  and  the  perinaeal  mus- 
cles. 

[The  fibres  of  the  larger  portion  of  this  muscle  form  a  canal  through  which 
the  bulbus  corp.  spong.  and  a  portion  of  corp.  spongiosum  urethrsB  pass.  The 
origin  of  this  portion  of  the  muscle  is  the  tendinous  layer  between  Corp. 
spongiosum  and  the  under  surface  of  corpora  cavernosa,  whence  the  fibres  de- 
scend, embracing  the  sides  of  the  spongy  body  and  bulb,  and  unite  below  in 
the  central  line  or  raphe,  which  posteriorly  consists  of  very  condensed  tissue. 
The  fibres  of  the  smaller  portion  arise  from  the  pubes  by  the  sides  of  the  lig. 
suspensor  penis,  and,  descending  upon  the  outer  borders  of  the  crura  penis, 
from  which  likewise  a  few  fibres  arise,  they  unite  in  the  middle  line  of,  and 
beneath,  the  corp.  spongiosum  urethra  anterior  to  the  fibres  of  the  larger  por- 
tion. The  posterior  extremity  of  the  muscular  tube  is  applied  to  the  anterior 
surface  of  the  deep  perinaeal  fascia.  TRANS/] 

Use:  to  compress  the  bulb,  urethrse  and  corp.  cavernosum 
urethrse,  to  contract  the  canal  of  the  urethra,  urging  forward  the 
urine  or  semen  by  jerks,  or  restraining  their  passage. 

278.  9.  Constrictor  cunni  s.  vaginas. 

Pos. :  circular  around  the  entrance  into  the  Vagina.  Or. :  M. 
sphincter  ani  and  transv.  perinsei.  Ins.:  Crura  clitoridis  (in- 
ferior surface).  Use:  to  contract  the  Vagina.  [Or.:  from  the 
under  surface  of  crura  clitoridis  meeting  below,  after  having  em- 
braced the  sides  of  the  vagina  and  nymphsR.~] 

279.  10.   Constrictor  urethrse. 

Pos.:  below  lig.  perinssale  about  the  pars  memb.  urethras. 
Between  it  and  transv.  perin.  (profund.),  the  glands  of  Cowper. 
Or.:  os  Ischii  (ram.  ascendens).  Ins.:  isthmus  urethras  (sides). 
Use :  to  compress,  and  shorten  the  membranous  portion  of  the 
urethra. 

280.  11.  Vesicalis  s.  depressor  vesicse. 

Pos.:  at  the  inferior  part  of  the  urinary  bladder.  Or.:  a.  lig. 
pubo-vesicale  ;  b.  lig.  ischio-prostaticum.  Ins. :  close  above  the 
Prostate  on  the  anterior  and  lateral  surfaces  of  the  bladder.  Use : 
to  draw  the  bladder  downwards  (for  example,  while  making  water 
in  recumbent  position). 

Nerves  of  anal  and  perinaeal  muscles :  pudend.  common,  and  fuemorrkoid. 


THE  MUSCLES.  157 

281.  Fascia  perinaei. 

The  general  subcutaneous  fascia  is  connected  before  with  Tu- 
nica  dartos  (or  the  fibro-cellular  tissue  of  the  labia),  behind  with 
the  sphincter  ani  and  coccyx ;  is  near  the  anus  membranous, 
contains  fat,  and  is  placed  over  the  fossa  perinxi. 

282.  a.  The  proper  perinaeal  fascia  (f.  p.  superficial.}  has  an 
anterior  and  a  posterior  segment. 

1.  Anterior  segment  (aponeur.  ischio-pubica),  from  arcus  pubis 
of  the  Ischium  and  pubis  as  far  as  tuber  ischii,  covers  in  the 
male :  m.  transv.  (superf.),  ischio-cavern.,  and  bulbo-cavernos., 
and  passes  over  anteriorly  upon  the  Penis ;  in  the  female  it  di- 
vides anteriorly,  covers  with  the  internal  layer  the   constrictor 
vaginx,  reaches  in  the  labium  min.  as  far  as  the  clitoris;  the  ex- 
ternal lies  in  the  entire  length  of  the  labia  majora. 

2.  Posterior  segment  (apon.  ischio-rectalis)  connected  in  front 
with,  1. ;  covers  the  fossa  perinsei ;  the  internal  layer  covers  the 
external  surface  of  the  lev.  and  sphincter  ani;  the  external  the 
posterior  part  of  the  obturator  intern.,  and  confined  below  to  the 
tuber  ischii,  lig.  tuberoso-sacrum  and  glut&us  maximus. 

Fossa  perinaei  [Ischio-rectal  fossa],  a  conical  fossa,  the  base  of 
which  corresponds  with  the  skin,  is  formed,  anteriorly,  by  transv. 
perin.,  behind  by  the  inferior  border  of  glutseus  maximus,  inter- 
nally by  levator  ani,  externally  by  tuber  Ischii.  It  is  filled  up 
with  fat  and  fibrous  stria?. 

283.  b.  Lig.  perinseale,  s.  fascia  perinsei  profunda,  a  three- 
sided  ligament ;  closes  the  anterior  portion  of  the  pelvic  outlet  (as, 
levat.  ani  the  posterior),  is  perforated  by  the  urethra;  arises  from 
os  Pubis  and  Ischium,  between  lig.  arcuatum  (in  front)  and  m. 
ischio-cavernos.  (behind) ;  below  nerv.  and  art.  penis.     The  an- 
terior portion,  covered  with  venous  plexuses,  lies  above  and  at  the 
sides  of  pars  membran.  urethrse  (presenting  an  obstruction  in 
catheterism) ;  the  posterior  portion  lies  below  the  urethra.   ; 

284.  c.  Fascia  pelvis  lines  the  cavity  of  the  small  pelvis. 
Or. :  close  before  arcus  pubis  ligamentous  (lig.  pubo-vesicale),  £ 
inch  from  that  of  the  other  side,  so  that  an  oval  fossa  remains 
between  the  ligaments  and  collum  vesicse,  where  they  unite ;  far- 
ther, from  pars  horizontal,  of  os  pubis;  at  the  superior  angle  of 

for.  obturator,  an  opening  remains  (for  nerv.  and  vasa  obtura- 
tor.) ;  then  from  linea  arcuata  as  far  as  to  symphys.  sacro-iliaca. 
Ins.:  as  far  as  the  origin  of  lev.  ani  single;  it  then  divides  ;  the 
anterior  portion  passing  on  the  side  of  the  urinary  bladder,  Pros- 
tate (vagina),  and  rectum;  the  posterior,  behind  the  rectum,  to 
the  middle  line,  as  far  as  the  os  coccygis. 


158  SPECIAL  ANATOMY. 

VII.  Muscles  of  the  Upper  Extremity. 
A.  On  the  Scapula. 

285.  1.  Deltoideus,  Jlttollens  humeri. 

Pos. :  envelopes  like  a  cap  the  head  of  the  upper  arm  and  its 
superior  third ;  beneath  the  skin ;  anterior,  external  to  and  behind 
the  shoulder  joint,  separated  from  it  by  a  tendinous  layer;  covers 
the  tendons  of  pectoral,  major  and  minor,  coraco-brachialis, 
biceps,  infraspinatus,  teres  minor,  triceps  brachii,  Vasa  et  Nn. 
circumflexi  humeri.  The  anterior  border  is  separated  from  the 
external  border  of  pectoral,  major  by  Vena  cephalica.  Or. : 
Spina  scapulas,  Jlcromion,  Pars  acromialis  claviculse  (as  M. 
cucullaris].  Ins.:  with  three  tendons  to  the  extremity  of  Spina 
tuberc.  majoris  oss.  humeri,  almost  in  its  centre.  Use:  1.  the 
central  fibres  raise  the  arm  directly  outwards  and  upwards ;  2. 
the  anterior  forwards;  3.  the  posterior  backwards. — The  arms 
being  fixed  (as  in  climbing),  it  draws  the  scapulae  towards  them. 
— Antagonist:  m.  cucullaris. 
Nerves:  axittaris  [drcumflexus]. 

286.  2.  Supraspinatus. 

Pos. :  in  ihe  fossa  supraspinata,  below  lig.  coraco-acromiale, 
over  the  roof  of  the  shoulder  joint,  covered  by  M.  trapezius ; 
above  Vasa  and  Nn.  supra  scapular es.  Or. :  fossa  supraspinata 
(the  two  internal  thirds).  Ins. :  tuber culum  majus  (at  the  highest 
point).  The  tendon  is  connected  with  the  articular  capsule,  sepa- 
rated from  that  of  m.  subscapularis  by  cap.  long,  bicipitis.  Use. : 
assists  in  elevation  of  the  arm  and  rotation  outwards. 

Nerves :  suprascapularis. 

287.  3.  Infraspinatus. 

Pos. :  below  the  spine  on  the  posterior  surface  of  the  scapula, 
covered  by  latissimus  dor  si,  cucullaris,  and  deltoid.,  and  a  strong 
fascia.  Or. :  fossa  infraspinata  (the  entire  surface).  Ins. :  1u- 
berculum  majus  (the  central  fossa) ;  connected  with  supraspin. 
and  teres  minor.  Use :  to  rotate  the  arm  outwards. 

Nerves:  suprascapular. 

288.  4.   Teres  Minor. 

Pos. :  on  the  external  border  of  the  scapula,  behind  the  Cap. 
long.  m.  tricipitis,  before  Vasa  and  Nn.  scapular,  super,  above 
upon  the  capsule  of  the  shoulder,  covered  by  deltoid.  Or. :  mar  go 


THE  MUSCLES.  159 

externus  scapula  (behind),  united  with  the  preceding  muscle. 
Ins. :  tuberculum  majus  (inferior  fossa) ;  vertical,  strong  tendon, 
1"  broad.  Use  :  like  the  preceding ;  to  draw  the  arm  backwards, 
and  lower  it,  if  raised  ;  prevents  the  escape  of  the  head  of  the  hu- 
merus  backwards. 

Nerves:  axittaris  [circumflexus], 

289.  5.   Teres  Major. 

Pos. :  at  the  inferior  external  border  of  the  preceding  muscle, 
before  Cap.  long,  tricipitis  ;  assists  in  forming  the  posterior  border 
of  the  axillary  fossa.  Or. :  Margo  extern,  and  Angul.  inferius 
Scapulse,  united  with  latissimus  dorsi.  Ins. :  Spina  tuberculi 
minoris ;  two  inches  broad,  behind  the  tendon  of  latissimus. 
Use :  to  rotate  the  arm  inwards,  drawing  it  backwards  towards 
the  central  line  (like  ani  sculptor). 

Nerves:  axillar.  and  suprascapularis. 

290.  6.  Subscapularis. 

Pos. :  on  the  anterior  surface  of  Scapula,  between  the  external 
third  of  which  and  it;  cellular  tissue  and  Vasa  and  Nn.  subsca- 
pulares.  Before  it:  M.  serratus  ant.  magn.,  Vasa  and  Nn.  axil- 
lares,  Mm.  coraco-brachial.  and  deltoides.  Or. :  fossa  scapularis 
(two-thirds  of  the  surface).  Ins. :  tuberculum  minus  oss.  humeri. 
Its  tendon  glides  in  the  concavity  of  Proc.  coracoid.,  between 
the  tendons  of  M.  biceps  and  coraco-brachialis,  as  in  a  pulley. 
Use :  to  rotate  the  arm  inwards,  drawing  it  downwards. 

Nerves:  subscapulares. 

Fasciae  Scapulae. 

291.  1.  F.  supraspinata,  is  firmly  attached  to  the  borders 
of  the  fossa  supraspinata,  encloses  the  muscle,  and  loses  itself 
externally  beneath  rfcromion  and  Proc.  coracoideus. 

2.  F.  infraspinata,  fixed  to  the  borders  of  fossa  infraspin., 
covers   and  separates  the  Mm.  infraspinal.,  teres  minor  and 
major  ;  loses  itself  externally  in  the/,  brachialis,  since  a  super- 
ficial layer  covers  M.  deltoideus,  a  deep,  the  tendon  of  M.  infra- 
spinatus,  and  attaches  itself  to  the  tendon  of  Caput  breve  m.  bici- 
pitis. 

3.  F.  subscapularis ;  covers  the   muscle  of  the   same  name, 
and  is  connected  on  the  borders  of  fossa  subscapularis  with  the 
preceding  and  with/,  lumbo-dorsalis. 


160  SPECIAL  ANATOMY. 

B.  Muscles  of  the  Upper  Arm. 
a.  Regio  humeri  anterior. 

292.  1.  £iceps  brachii  (flexor  radii). 

Position  :  on  the  anterior  internal  surface  of  the  upper  arm  ;  the 
heads  on  the  outer  side  of  the  axilla,  betwoen  pectoral,  major  and 
deltoid  before,  latissim.  dor  si  and  teres  major  behind ;  the  long 
head  before  m.  subscapular.  Behind  its  belly :  Nerv.  musculo- 
cutan.,  M.  coraco-brachial.,  brachial.  internus;  along  the  internal 
border:  Art.,  Vv.  brachiales,  Nerv.  medianus.  Or.:  1.  Caput 
longum — cavit.  glenoid.  scapul.  (at  the  upper  edge).  2.  Cap. 
breve — Proc.  coracoideus  (apex).  Ins.:  tuberositas  radii;  the 
tendon  is  surrounded  by  Supinator  brevis;  an  aponeurosis 
passes  over  from  it  into  the  fascia  cubiti.  Use :  to  flex  and 
draw  the  fore-arm  rather  inwards ;  stretches  the  fascia  anti- 
brachii. 

293.  2.  Brachialis  internus,  flexor  of  the  elbow. 

Pos. :  behind  the  last  muscle  ;  upon  the  inner  border :  N.  Me- 
dian., Art.  brachial.,  below  M.  pronator  teres;  on  the  outer 
border:  'N.  radialis  and  M.  supinator  longus. 

Or. :  Os  humeri  (inner  surface) ;  surrounding  the  insertion  of 
M.  deltoideus.  Ins. :  Proc.  coronoideus  ulnae. 

Use :  flexes  the  fore-arm,  and  draws  it  rather  outwards. 

294.  3.  Coraco-brachialis  (s.  perforatus  Casserii}. 

Pos. :  above,  under  deltoideus,  in  the  centre  between  pectoral, 
maj.  and  latissim.  dorsi,  below  at  a  similar  elevation  as  the  ten- 
don of  deltoideus  ;  covers  above,  Art.  axillar.  and  brachial.,  Nn. 
medianus  and  musculo-cut.,  lies  below  to  the  outer  side  of  Art. 
brachialis.  Or. :  Proc.  coracoideus  (apex).  Ins.  :  Os  humeri 
(inner  border  and  centre)  between  anconxus  quartus  [short  head 
of  triceps]  and  brachial.  internus.  Use:  presses  the  scapula  and 
humerus  towards  one  another ;  assists  in  drawing  the  arm  to  the 
chest.  Antagonist  to  the  rotators. 

Nerves :  (first  to  third)  musculo  cutaneus. 

b.  Regio  humeri  posterior. 

295.  4.  Triceps  (s.  brachialis  externus,  s.  anconseus  magnus). 

Pos.  :  on  the  posterior  external  surface  of  the  upper  arm,  sepa- 
rated from  the  skin  byfasc.  brachialis,  covers  the  nerv.  radialis 


THE  MUSCLES.  161 

and  art.  humeri  profunda.  The  long  head  lies  before  M.  deltoid. 
and  teres  minor,  behind  M.  subscapularis,  teres  major,  latissim. 
dor  si.  Or. :  1.  Caput  longum  from  external  border  of  Scapula, 
close  beneath  the  articular  fossa  ;  between  teres  major  and  minor. 
2.  Cap.  externum  from  the  external  border  of  humerus  to  below 
the  centre.  3.  Cap.  internum  from  the  internal  border  ;  as  far 
almost  .as  the  condyle.  Ins.:  Olecranon  (posterior  surface  and 
lateral  borders).  Use  :  to  extend  the  fore-arm. 
Nerves :  axillar.,  radialis. 

296.  5.  Ancon&us  parvus. 

Pos. :  behind  the  elbow,  short,  triangular,  continuation  of  Cap. 
extern.,  M.  tricipitis.  Or. :  close  behind  Condylus  externus 
humeri.  Ins. :  the  superior  external  third  of  the  Ulna.  Use  : 
to  extend  the  fore-arm. 

Nerves:  radialis. 

297.  6.   Subanconseus  (of  Theile). 

A  thin  muscular  fasciculus.  Or.:  above  the  fossa  inter  condyl. 
poster.  Ins. :  Capsule  of  the  elbow  articulation.  Use  :  to  stretch 
the  capsule. 

298.  Fascia  brachialis  s.  humeri,  arises,  above,  from  Clavi- 
cula,  Jlcromion,  and  Spina  scapulse,  internally,  from  the  tendons 
of  pect.  major,  and  latissim.  dor  si  and  the  uniting  tissue  of  the 
axilla,  envelopes  the  arm  and  terminates  at  the  articulation  of  the 
elbow.     It  consists  almost  entirely  of  circular  fibres.     The  exter- 
nal surface  is  separated  from  the  skin  by  vessels  and  nerves  which 
the  fascia  provides  with  sheaths. 

From  the  internal  surface  two  septa  (ligg.  intermuscularia) 
pass  off,  which  separate  the  flexor  from  the  extensor  muscles 
(anconaei),  and  are  attached  to  the  external  and  internal  angles  of 
the  upper  arm. 

299.  Lig.  intermuscul.   externum  arises  from   the   anterior 
border  of  the  bicipital  groove,  and  from  the  tendon  of  Deltoideus, 
separating  the  brachialis  intern,  from  the  triceps;  is  perforated 
by  nerv.  radialis  and  art    brachial.  profunda,  which,  at  their 
commencement,  run  in  the  posterior,  then  in  the  anterior  region 
of  the  arm.     Lig.  intermuscul.  intern,  by  nerv.  ulnaris,  which 
runs  first  before,  then  behind  it.     The  particular  sheaths  which 
pass  off  from  these  two  large  ones  are : — • 

1.  For  M.  deltoideus,  arises  from  the  posterior  border  of  bi- 
cipital groove  below  teres  major,  and  from  the  tendon  of  coraco- 
brachialis;  is  thicker  and   triangular.     2.  Sheath  between  M. 
biceps  and  brachialis  intern.     3.  Canalis  brachialis,  for  Vasa 
11 


162  SPECIAL  ANATOMY. 

brachialia  and  nerv.  medianus,  forming  on  the  inner  side,  below 
the  centre  of  the  upper  arm  a  semihmar  fissure,  receives  Ven. 
basilica  and  Nn.  ulnaris  and  cutaneus  intern.,  and  connects  the 
uniting  tissue  of  the  axilla  with  that  at  the  bend  of  the  elbow. 
4.  Sheath  for  caput  long.  m.  tricipitis  at  the  superior  half.  It 
is  stretched  by  m.  pectoral,  maj.  and  latissim.  dorsi. 

B.  Muscles  of  the  Fore-arm. 

a.  On  the  anterior  or  flexor  surface. 

a.  First  layer. 

300.  1.  Pronator  radii  teres. 

Pos. :  oblique  from  above  to  below,  from  within  to  without; 
external  to  M.  palmar,  long,  and  flex.  carp,  radialis ;  covered 
by  N.  median,  and  Art.  ulnaris.  Or. :  Condylus  internus  hu- 
meri £and  ulnar  border  of  coronoid  process]  ;  externally  M.  bra- 
chialis  intern,  and  biceps.  Ins. :  Centre  of  the  radius  (in  front 
and  on  outside)  covered  by  M.  supinator  longus.  Use :  rotates 
the  radius  inwards.  [Nerv.  median,  perforates  the  muscle.] 

Nerves :  medianus. 

301.  2.  Flexor  carpi  radialis  (s.  radialis  internus). 

Pos. :  next  to  the  last  described  muscle,  internally ;  with  a 
strong  tendon  projecting  out  beneath  the  skin,  on  its  external  bor- 
der the  Art.  radialis  (Pulse).  Or.:  Condyl.  intern,  humeri ; 
internal  to  M.  pronat.  teres.  Ins. :  Basis  of  os.  metacarp.  II. 
Use:  to  flex  the  hand  towards  the  radial  side. 

Nerves:  medianus. 

302.  3.  Palmaris  longus  (sometimes  wanting). 

Pos. :  the  spindle-shaped  belly  in  a  groove  upon  flex,  digitor. 
sublim.,  and  close  to  the  last  muscle,  internally,  with  a  long  su- 
perficial tendon  in  a  strong  sheath.  Or. :  Condyl.  intern,  humeri. 
Ins. :  Aponeurosis  palmaris.  Use :  stretches  the  aponeurosis 
palmaris  and  flexes  the  hand. 

Nerves :  medianus. 

303.  4.  Flexor  carpi  ulnaris  (s.  ulnaris  internus). 

Pos. :  on  the  inner  border  of  the  Ulna.  Art.  ulnaris  at  first 
beneath  it,  then  along  the  outer  border  of  its  tendon.  Or. :  Condyl. 
intern,  humeri,  and  Olecranon  (internal  border ;  beneath  it  nerv. 
ulnaris).  Ins.:  Os  pisiforme.  Use:  to  flex  the  hand  towards 
the  ulnar  side. 

Nerves:  ulnaris. 


THE  MUSCLES.  163 

0.  Second  layer. 

304  5.  Flexor  digitorum  communis  sublimis  (s.  perforatus). 

Pos.:  beneath  the  four  muscles  last  described.  Covers  the 
following  muscle  and  nerv.  medianus  ;  passes  under  Lig.  carpi 
volar.  propr.  The  four  tendons  are  perforated  in  the  region  of 
the  first  phalanx  by  those  of  the  following  muscle.  Or. :  1 . 
Condyl.  intern,  hum.  2.  Inner  side  of  Proc.  coronoid.  Ulnss. 
3.  interior  border  of  Radius.  Ins. :  Lateral  surfaces  of  Pha- 
lanx II.  of  the  second  to  the  fifth  finger.  Use  :  to  flex  the 
second  phalanx  of  the  second  to  the  fifth  finger. 

y.  Third  layer. 

305.  6.  Flexor  digitorum  communis profundus  (s.perforans). 
Pos.:  beneath  the   before   mentioned  muscles,  covering   the 

Ulna,  in  the  palm  of  the  hand,  the  Mm.  interossei  and  adductor 
pollicis.  Or.:  1.  Jlngulus  intern.  Ulnae  (above  and  internally). 
2.  Lig.  interosseum  (two-thirds).  Ins.  :  Basis  Phalang.  III. 
of  the  second  to  the  fifth  finger.  Use :  to  flex  the  ungual  pha- 
lanx of  the  second  to  the  fifth  finger. 
Nerves :  (5)  medianus,  (6)  median,  [et  ttlnaris]. 

306.  7.  Flexor  Pollicis  longus. 

Pos. :  external  and  close  to  the  last  muscle  ;  covers  the  radius 
and  lig.  inteross.  Or. :  1.  Mar  go  intern.  Radii  (three-fourths). 
2.  Lig.  interosseum:  Ins, :  Basis  Phalang.  II.  of  the  thumb. 
Use  :  to  flex  the  ungual  phalanx  of  thumb. 

Nerves :  interosseous  internus. 

S.  Fourth  layer. 

307.  8.  Pronator  quadratus. 

Pos. :  at  the  inferior  extremity  of  the  anterior  surface  of  the 
forearm,  close  upon  the  bones,  beneath  Jlrtt.  radialis  and  ulnaris. 
Or. :  Angul.  intern.  Ulnx  (the  lower  fourth).  Ins. :  angul. 
anticus  et  Marg.  intern.  Radii.  Use :  rotates  the  inferior  ex- 
tremity of  the  radius  upon  the  ulna,  thus  pronates  the  hand. 

Nerves :  interosseous  internus. 

b.  Muscles  upon  the  outer  surface  of  the  fore-arm. 

308.  9.   Supinator  longus  s.  brachio-radialis. 

Pos. :  between  the  volar  and  dorsal  surface  of  the  arm  ;  in  the 
upper  arm,  internal  and  close  to  it,  brachial.  intern.,  separated 
by  nerv.  radial.,  then  upon  it ;  covered  by  the  skin,  upon  pronat. 
teres,flex.  pollic.  long.,  along  the  inner  border,  upon  the  fore- 


164  SPECIAL  ANATOMY. 

arm,  Art.  radial.,  which  commences  beneath  it.  Or.:  \.Marg. 
extern,  oss.  humeri  (inferior  one-fourth).  2.  Li  g.  inter  muscular. 
and  Condyl.  extern.  Ins. :  Basis  proc.  styloid.  Radii.  Use  : 
rotates  the  radius  outwards  until,  at  last,  it  rather  flexes  the  fore- 
arm. 

Nerves :  radialis,  inteross.  extern. 

309.  10.  Extensor  carpi  radialis  longus  (s.  radialis 

externus  longus). 

Pos. :  For  two-thirds  of  its  length  covered  above  by  the  last 
muscle,  above  and  upon  the  carpus  by  M.  abductor  and  extensor 
pollic.  long.,  on  its  inner  edge  passes  Art.  radial.  Or. :  Angul. 
externus  humeri — Lig.  inter musculare  externum.  Ins. :  Os 
Metacarpi  II.  (Basis,  dorsal  surface). 

310.  11.  Extensor  carpi  radialis  brevis. 

Pos. :  beneath  the  last  muscle,  covers  the  outer  surface  of  the 
Radius;  to  the  inner  side  of  m.  extensor  digit,  commun.  Or.  : 
1.  Condylus  extern,  humeri.  2.  Fascia  cubiti.  Ins.  :  Os  me- 
tacarpi  HI.  (Basis,  dorsal  surface).  Use :  to  extend,  like  the 
former  muscle,  the  hand,  and  draw  it  towards  the  radial  side 
(that  is,  it  abducts  it). 

Nerves :  (tenth  and  eleventh)  radial,  superfic.  and  profound. 

311.  12.   Supinator  brevis. 

Pos. :  broad,  on  the  superior  half  of  the  radius,  winding  around 
it,  obliquely  from  above  downwards  ;  beneath  anconseus  parvus, 
extensor  digit,  commun.  and  carpi  ulnar.  Or. :  1 .  Lig.  laterale 
extern.  2.  Margo  extern.  Ulnse  (below  fossa  sigmoid.).  Ins.: 
Radius  (anterior  inner  surface  one  half).  Use  :  rotates  the  upper 
half  of  the  radius  outwards. 

Nerves:  inteross.  extern.  [This  muscle  is  perforated  by  a  branch  of  the 
radio-spiral  nerve.] 

c.  Muscles  upon  the  dorsal  surface, 
a.  Superficial  layer. 

312.  13.  Extensor  digitorum  communis. 

Pos.  :  between  m.  extens.  carpi  radial,  breve  and  ulnaris, 
covers  M.  supinat.  brevis,  abduct,  long,  and  brevis,  extensor 
long,  pollicis,  extens.  indicis,  the  back  of  the  carpus,  the  meta- 
carpus, and  fingers.  Or. :  Condyl.  extern,  humeri.  Ins. :  Pha- 
lang.  II.  and  III.  of  the  second  to  the  fifth  finger ;  four  tendons, 
each  of  which  divides  into  three  portions.  The  tendon  of  the 
second  finger  is  more  free  than  the  rest.  Use :  to  extend  the 
second,  third,  fourth,  and  fifth  fingers. 

Nerves :  inteross.  extern,  and  radial,  dorsal. 


THE  MUSCLES.  165 

313.  14.  Extensor  digiti  minimi  proprius. 

Pos. :  internal  and  close  to  the  former,  to  the  outer  side  of  the 
following  muscle.  Or.:  united  with  the  former  muscle  from 
Condyl.  extern.  Ins. :  united  with  the  tendon  of  the  M.  extens. 
commun.  on  the  fifth  finger.  Use :  assists  in  extending  the  fifth 
finger.  This  muscle  is  often  wanting. 

314.  15.  Extensor  carpi  ulnaris  (s.  ulnaris  externus}. 

Pos. :  on  the  ulnar  border,  covers  the  Ulna,  M.  supinat.  brevis, 
and  the  deep  layer.  Or. :  Condylus  externus  humeri  and  the 
Ulna  (the  central  third  of  the  posterior  border).  Ins. :  Basis 
oss.  metacarpi  V.  Use :  to  extend  the  metacarpus  and  draw 
(adduct)  it  rather  inwards. 

/3.  Deep  layer. 

315.  16.  Abductor pollicis  longus  [Extens.  primi  internodii}. 
Pos. :    the  most  external,  covered  by  extens.  com.,  upon  lig. 

inteross.,  Radius,  the  tendons  of  Mm.  extens.  radial,  and  the 
outer  side  of  the  carpus.  Or. :  1.  Crista  ulnse  (below  supinator 
brevis)  on  the  second  fourth.  2.  Lig.  inteross.  and  Radius  (pos- 
terior surface).  Ins. :  Basis  oss.  metacarp.  I.,  the  free  tendon  in 
a  sheath.  Use  :  to  draw  the  thumb  from  the  other  fingers  ;  assists 
in  extending  the  hand  and  drawing  it  backwards. 

316.  17.  Extensor.pollicis  brevis  [Ext.  secundi  internodii^. 
Pos. :  internal,  and  close  to  the  former  muscle,  only  separated 

from  it  by  a  tendinous  sheath.  Or. :  1.  Jlngulus  extern.  Ulnse.  [?] 
2.  Lig.  inteross.  and  Radius.  Ins. :  Basis  Phalang.  I.  pol- 
licis. Use :  to  extend  the  first  phalanx,  and  then  abduct  the  Os 
metacarpi  I. 

317.  18.  Extensor  pollicis  longus  [Ext.  tertii  internodii}. 
Pos. :   between  abduct,  longus  and  extens.  brevis  pollic.     Its 

tendon  crosses  over  extens.  radiall.  (tendons),  and  is,  on  the  car- 
pus, separated  from  the  tendon  of  abductor  longus  by  a  fossa. 
Or. :  Ulna  (external  surface,  inferior  half)  and  lig.  inteross.  Ins. : 
Basis  phalang.  II.  pollicis.  Use  :  extends  the  ungual  phalanx 
of  the  thumb. 

318.  19.  Extensor  indicis  proprius. 

Pos. :  along  the  inner  border  of  the  former  muscle,  below  it 
and  m.  extens.  carpi  ulnar.  and  digit,  commun.  Or. :  Ulna  (ex- 
ternal angle,  middle)  and  lig.  inteross.  Ins. :  the  inner  side  of 
the  tendon  of  extens.  comm.  of  second  finger,  on  the  second  and 
third  phalanx.  Use  :  to  extend  the  index  finger. 

Nerv.  (fourteenth  to  nineteenth)  interosseus  externus. 


166  SPECIAL  ANATOMY. 

319.  Fascia  antibrachii  s.  vagina  cubiti,  passes  off  from  the 
f.  brachii,  enveloping  the  entire  fore-arm  as  far  as  the  Crista  ulnss, 

serving  at  the  upper  part  more  especially  for  the  attachment  of 
muscles.  Fibrous  striae  serve  to  strengthen  it  which  come  off 
behind,  from  the  triceps,  on  the  outside,  from  brachial  intern., 
and  in  front  and  internally  from  biceps,  as  well  as  those  from  the 
condyles  of  the  Humerus.  Aponeurosis  bicipitis  passes  over 
pronator  ter.es  like  a  bridge  at  the  bend  of  the  arm,  from  the  outer 
border  and  the  anterior  surface  of  Biceps  tendon,  inwards  and 
downwards  ;  covering  art.  brachialis.  Besides  several  vascular 
and  nervous  openings,  one  should  be  observed  in  the  fascia  anti- 
brachii at  the  bend  of  the  arm  (on  the  outer  border  of  aponeurosis 
bicipitis),  through  which  the  uniting  tissue  beneath  the  skin  com- 
municates with  that  under  the  fascia,  and  which  leads  to  a  fossa 
in  which  the  following  parts  are  situated :  Tendon  of  m.  biceps, 
Art.  brachialis,  commencement  of  Art.  radial.,  Nerv,  medianus. 
The  fossa  is  formed :  on  the  outside  by  supinator  long.,  extensores 
carpi  radial.,  flexor  sublimis;  on  the  inside  by  pronator  teres; 
and  communicates  above  with  the  canal  of  the  Art.  brachial., 
below  with  those  of  the  Art.  radial.,  ulnaris,  interossea,  and 
Nerv.  medianus.  In  consequence  of  the  attachment  of  the  f. 
antibrachii  to  the  internal  angle  of  Radius  and  the  internal  sur- 
face of  Ulna,  a  sheath  arises  from  the  muscles  of  the  Volar  and 
another  for  those  of  the  Dorsal  surface,  and  besides,  by  inversions, 
sheaths  for  the  individual  muscles.— -At  the  Carpal  articulation  it 
forms, 

320.  a.  Lig.  carpi  volare;  arises  internally,  1.  from  Os  pisi- 
forme,  2.  from  Os  hamatum,  and  continues  externally,  as  it  passes 

over  befor  the  Volar  surface  of  the  carpus,  to  the  Os  naviculare 
and  Trapezium.  Behind  it  lie,  with  one  (or  two)  synovial  cap- 
sules, the  nine  tendons  of  the  flexor  muscles  and  nerv.  medianus 
in  one  bundle.  Its  superficial  layer,  lig.  carpi  volare  commune, 
is  thin,  its  deep  layer,  lig.  carpi  volare  proprium,  strong.  From 
both  the  aponeurosis  palmaris  springs. 

321.  b.  Lig.  carpi  dorsale  commune,  very  fibrous,  passes 
obliquely  from  crista  radii  over  the  radio-ulnar  articulation  to 
the  os  triquetrum  and  the  basis  of  the  five  metacarpal  bones,  and 
then  passes  into  thefasc.  manus  dorsalis.     Prolongations  which 
pass  off  from  the  internal  surface  of  Lig.  dors,  form  the  following 
tendinous  sheaths,  from  without  inwards:  1.  for  abductor  long. 
and  extens.  brevis  pollicis.    2.  and  3.  for  extens.  carp,  radiates 
and  extens.  pollicis  longus  (associated   together   below  in   one 
sheath).     4.  for  extensor  digitor.  commun.  and  indicator.     5. 
extens.  digiti  V.  proprius.    6.  for  extensor  carpi  ulnaris. — Each 
tendon  enjoys  its  own  synovial  capsule. 


THE  MUSCLES.  167 

D.  Muscles  on  the  Hand. 
321.'»u-  a.  Muscles  of  the  ball  of  the  Thumb  (thenar). 

a.  Attached  to  the  outer  side  of  Os  Metacarpi  I.  or  Phalanx  I. 

322.  1.  Abductor  pollicis  brevis. 

Pos. :  the  most  superficial  on  the  outer  border  of  os  metacarp. 
/.,  separated  from  opponens  beneath  it,  by  a  fascia.  Or. :  Lig. 
carpi  volare  propr.  (radial  side)  Tuber  Trapezii.  lns.:-£asis 
of  /.  phalanx.  Use. :  abducts  the  thumb  from  the  index  finger. 

323.  2.   Opponens  pollicis. 

Pos. :  beneath  the  former  muscle  ;  internal  portion  only  covered 
with  skin ;  above  flex,  pollicis  brevis  and  tendon  of  the  longus. 
Or. :  like  the  former  muscle.  Ins. :  Radial  border  of  os  metacarp. 
/.  Use :  to  draw  the  thumb  inwards  and  forwards  (towards  the 
little  finger). 

324.  3.  flexor  pollicis  brevis. 

Pos. :  oblique  downwards  and  outwards,  on  the  external  border 
covered  by  abduct,  brevis,  on  the  internal  united  with  adduct. 
pollicis.  Or. :  the  same  as  before,  and  from  the  tendinous  sheath 
of  flexor  radial  carpi.  Ins.:  Os  sesamoideum  externum  and 
Phalanx  /.  (covered  externally  by  the  tendon  of  adduct.  pollicis). 
Use:  to  draw  the  phalanx  inwards  and  forwards  (M.  opponens 
internus). 

)3.  Attached  to  the  Ulnar  side  of  the  first  phalanx  of  the 
Thumb. 

325.  4.  Adductor  pollicis. 

Pos. :  triangular,  between  Os  metacarpi  7.  and  //.,  covered  by 
the  tendons  of  flexor  dig.  prof,  and  lumbricales.  The  deep 
portion  (Cap.  prof und.  M.  flex.  poll,  brev.)  close  to  the  former 
muscle;  the  superficial  close  beneath  the  skin.  Or.:  1.  Os  meta- 
carpi III.  (the  entire  anterior  border).  2.  Os  trapezium  (anterior 
superior  part).  Ins. :  Os  sesamoideum  internum  and  Phalanx  I. 
Use :  to  draw  the  thumb  towards  the  index  finger. 

Nerves:  (first  to  the  fourth)  medianus  and  ulnaris. 

b.  Muscles  on  the  ball  of  the  little  finger  (hypothenar.).     At- 
tached to  the  ulnar  side. 

328.  5.  Abductor  digiti  minimi. 

Pos.:  on  the  internal  (ulnar)  border  of  Os  metacarpi  F., 
covers  oppon.  dig.  V.  Or. :  Os  pisiforme  and  aponeurosis  of 


168  SPECIAL  ANATOMY. 

M.flex.  ulnar.  carpi.  Ins.:  Basis phalang.  I.  digiti  V.  Use: 
to  draw  the  little  finger  inwards  (that  is  to  say,  from  the  fourth 
finger). 

327.  6.  Flexor  digiti  V.  brevis. 

Pos. :  on  the  outer  border  of  the  last  muscle,  separated  from  it 
by  Vasa  and  Nn.  ulnares.    Or. :  Os  hamatum  (the  process,  unci- 
form.)  and  lig.  carp.  vol.  propr.     Ins. :  Basis  phalang.  I.  digiti 
V.     Use  :  to  flex  a  little  thejirst  phalanx  of  the  fifth  finger. 

328.  7.   Opponens  digiti  V. 

Pos. :  covered  by  the  last  muscles,  above  the  interosseus  and 
the  tendon  of  flex,  digit,  comm.  of  the  fifth  finger.  Or. :  Os 
Hamatum  (the  process).  Ins.:  capitulum  and  the  whole  ulnar 
side  of  os  metacarpi  V.  Use  :  to  draw  the  fifth  metacarpal  bone 
outwards  and  forwards  (that  is,  towards  the  thumb  in  making  the 
hand  hollow). 

Nerves :  (fifth  to  the  seventh)  ulnaris  r.  profund.  volaris. 

c.  Muscles  in  the  middle  of  the  palm  of  the  Hand. 

329.  8.  Palmaris  brevis,  Cutaneous  muscle  of  hand. 
Pos.:  close  beneath  the  skin, in  the  fat  over  the  muscles  of  the 

little  finger  and  Art.  and  Nerv.  ulnaris;  transverse,  one  inch 
broad  and  long.     Or. :  Jlponeurosis  palmar,  media.     Ins. :  the 
skin  of  the  ulnar  border,  from  os  pisiforme  onwards.     Use: 
wrinkles  the  skin  on  the  ball  of  the  little  finger. 
Nerves :  ulnaris  r.  sublimis  volar. 

330.  9.  Lumbricales. 

Pos. :  beneath  Jlponeurosis  palmaris  on  the  four  tendons  of 
the  flexor  digit,  profundus,  in  the  hollow  of  the  hand.  Or. :  the 
radial  side  of  the  three  tendons  of  flex,  profund.  Ins. :  the 
radial  side  of  first  phalanx  of  the  second  to  the  fifth  finger; 
blending  with  the  tendons  of  extens.  digitor.  communis.  Use: 
flexes  the  first  phalanx  of  the  second,  third,  fourth,  and  fifth 
fingers. 

Nerves :  medianus,  for  the  fourth  ulnaris  r.  superfic. 

331.  10.  Interossei  volares  s.  interni,  3. 

Pos. :  in  the  spaces]  between  Ossa  metacarpi,  second  to  fifth, 
in  the  palm,  covered  before  by  the  flexors,  behind  by  the  m.  in- 
teross.  dorsales.  Or. :  sides  of  os  metacarpi  (two-thirds  of  the 
anterior  surface)  //.,  IV.,  V.  Ins. :  Phalanx  I.  of  second  (ulnar 
side),  fourth,  and  fifth  (radial  side)  fingers,  and  the  tendon  of  m. 
extens.  digitor.  communis.  Use,  to  draw  the  second,  fourth,  and 
fifth  fingers  towards  the  middle  finger. 


THE  MUSCLES.  169 

332.  11.  Interossei  dorsales  s.  bicipites,  4. 

Pos. :  in  the  spaces  between  Oss.  metacarpi  I.  to  V.,  to  be  seen 
from  the  back  and  palm  of  the  hand.  Or. :  sides  of  Ossa  meta- 
carpi II.  to  V.,  with  two  heads,  which  Art.  perforans  separates. 
Ins. :  1.  on  the  radial  side  of  Phalanx  I.  of  index  finger;  2.  the 
same  on  the  middle  finger ;  3.  on  the  Ulnar  side  of  the  middle 
finger;  4.  the  same  on  the  ring  finger.  Use:  draws  the  Index 
from  the  Middle  finger,  the  Middle  finger  from  the  Ring  and  In- 
dex, the  Ring  finger  from  the  Middle  ;  they  spread  out  the  second 
and  the  fourth  from  the  middle  finger. 

Nerves :  ulnaris  r.  profund.  volar. 

333.  1.  Aponeurosis  palmaris,  close  beneath  the  skin  of  the 
hollow  of  the  hand,  it  forms  a  sheath  for  all  its  muscles.     The 
central  portion  is  triangular  and  strong,  arises  from  the  anterior 
surface  and  the  inferior  border  of  Lig.  carpi  volar e  and  the  ten- 
don of  palmaris  longus  (between  the  two  points  Art.  ulnaris 
enters  into  the  palm  of  the  hand) ;  it  divides  in  the  region  of  the 
Capitul.  oss.  metacarpi  into  eight  parts  for  the  second  to  the  fifth 
fingers,  and  is  strengthened  by  transverse  fibres.     By  this  four 
arches  arise  for  the  tendons  of  Mm.  flexor  es,  and  three  between 
them  for  Vasa  and  Nn.  collaterals  of  the  fingers  and  Mm.  lum- 
bricales.     Loose  uniting  tissue  separates  the  middle  part  from  the 
subjacent   structures:    Jircus   arterios.   superficial.  vol&  ;    Nn. 
median,  and  ulnaris  tendin.  mm.  flexor.     Externally,  as  a  con- 
tinuation of  the  tendon  of  abductor  pollicis  longus,  the  external 
portion  of  the  Jlponeur.  palm,  envelopes  the  muscles  of  the  ball 
of  the  thumb ;  internally,  as  a  process  of  the  tendon  of  flexor 
carpi  ulnaris,  the  inner  portion,  the  muscles  of  the  ball  of  the 
little  finger ;  here  the  m.  palmaris  brevis  is  connected.     It  loses 
itself  on  the  first  phalanx  in  the  sheaths  of  flexor  digit,  and  ligg. 
capit.  os.  metacarpi. 

334.  2.  F.  dorsalis  manus. ;  a.  the  superficial  is  a  thin  layer, 
covering  the  tendons  of  extens.  digitor.  comm.,  and  attached  to 
the  second  and  fifth  metacarpal  bones  ;  b.  the  deep,  covers  the 
interrossei,  and  attaches  itself  to  all  the  metacarpal  bones,  con- 
sisting of  loose  elastic  uniting  tissue,  which  serves  instead  of 
synovial  capsules. 

335.  3.  Pulleys  (trochleae}  of  \heflex.  digitor.  comm.;  con- 
sist of  fibre-cartilaginous   portions  with  transverse  fibres,  lying 
transversely  before  all  three  phalangeal  articulations  of  the  second 
to  the  fifth  fingers.     On  the  first  joint  they  form  a  connected  flat 
surface  (one  inch  long),  to  which  the  aponeurosis  palmar,  is  at- 
tached. 


170  SPECIAL  ANATOMY. 

336.  Tendinous  sheaths  of  the  flexors  on  the  fingers ;  they 
consist  of  separate  ligaments,  as  : 

1.  Transverse  ligaments,  annuli,  narrow,  passing  before  each 
joint  transversely  in  front  of  the  tendons,  attached  to  the  basis 
phalang.  and  the  pulley. 

2.  Ligamentous  sheaths ;  broader,  transverse  before  the  bodies 
of  the  first  and  second  phalanx. 

3.  Crucial  ligaments,  ligg.  cruciata, before  the  first  and  second 
phalanx,  descending  obliquely  from  the  edges  of  the  body  to  the 
capitulum  of  the  phalanx. 

VIII.  Muscles  of  the  Inferior  Extremity. 
A.  Muscles  of  the  Thigh. 

337.  1.  Flexor  Femoris. 

a.  Psoas  Magnus  (Internal  Head). 

Figure  :  at  commencement  flat,  then  round  and  spindle-shaped. 
Pos. :  on  the  sides  of  the  bodies  of  the  lumbar  vertebrae,  between 
the  external  and  central  crura  of  the  diaphragm,  before  plex.  lum- 
balis,  quadratus  lumborum,  behind  the  kidneys,  then  on  the 
boundary  between  the  great  and  small  pelvis,  covered  by  perito- 
naeum ;  on  the  outer  side  nerv.  cruralis  passes.  Behind  it  meets 
with  quadratus  lumborum.  Or. :  first  to  the  fifth  lumbar  verte- 
brae (lateral  surface  of  bodies).  Ins.:  Trochanter  minor.  The 
tendon  passes  in  front  of  the  hip-joint  (with  a  synovial  capsule). 

338.  b.  Iliacus  (External  Head). 

Fig. :  broad,  three-sided.  Pos. :  fills  up  the  whole  venter  Ilii, 
covered  by  a  fascia,  fat  and  peritonaeum.  Passes  out  from  the 
pelvis,  united  with  psoas,  in  a  groove  between  spina  ilei  anter. 
infer,  and  eminent,  pectin.,  underneath  lig.  Poupart.  Upon  it, 
to  the  right,  are  placed  the  csecum  and  the  termination  of  the 
small  intestines ;  to  the  left,  the  colon.  Or.:  Fossa  Iliaca  and 
lig.  ileo-lumbale.  Ins. :  Trochanter  minor. 

On  the  thigh  they  lie,  both  united  together,  behind  n.  cruralis 
(in  one  sheath),  internal  to  Sartorius  and  rectusfemoris,  external 
to  the  adductores  and  art.  cruralis.  Use :  to  elevate  (flex)  the 
thigh  towards  the  trunk,  or  to  bend  the  trunk  forwards  over  the 
•thigh. 

Nerves :  cruralis  and  pkxus  lumbalis. 

339.  2.  Psoas  Minor  (often  wanting). 

Pos. :  on  the  internal  border  and  before  the  lumbar  portion  of 
the  former  muscle,  the  tendon  on  the  inner  edge  of  fascia  iliaca, 
crossing  the  Psoas  major.  Or. :  bodies  of  last  dorsal  and  first 


THE  MUSCLES.  17] 

lumbar  vertebrae.  Ins. :  Fascia  iliaca  at  the  posterior  part  of 
linea  arcuata.  Use:  stretches  the  fuse.  Iliaca;  may  flex  the 
pelvis  towards  the  trunk  (as  in  climbing),  or  draw  the  trunk  side- 
ways. 

340.  3.  Glutseus  maximus. 

Pos. :  one  inch  thick,  close  beneath  the  skin  of  the  buttocks  ; 
broad,  four-sided ;  covers  glut,  med.,  pyriform.,  gemelli,  obturat. 
intern.,  quadrat,  femor.,  incisttra  ischiad.  maj.,  tuber  ischii, 
Mm.  semitendin.  and  membranes.,  cap.  long,  bicipit.;  tro- 
chanter  major,  adductor  magn.,  Nn.  et  vasa  glutsea,  ischiadic., 
pudenda  interna.  Or.:  1.  posterior  surface  of  Ilium,  behind  lin. 
semicircul.  poster.  2.  spina  ilei  poster,  super,  as  far  as  cornu 
sacrale.  Ins. :  Linea  aspera,  the  external  crus,  close  under  tro~ 
chanter  major  femoris,  and  fascia  lata.  Use :  extends  the  thigh 
backwards,  draws  and  rotates  it  outwards  ;  or  draws  (when  stand- 
ing upon  one  leg),  the  pelvic  half  of  the  other  side,  backwards ; 
stretches  the  fascia  lata,  and  maintains  the  os.  coccygis  in  its 
situation. 

Nerves :  glutteus  infer. 

341.  4.  Glutseus  medius. 

Pos. :  behind  the  last,  covered' before  and  above  by  fat  and  skin, 
and  rather  by  m.  fasciae  latse.  Along  the  posterior  border,  m. 
pyriform. ;  on  the  outside,  Vasa  and  nerv.  Glutsei. 

Or. :  fossa  Iliaca  externa ;  the  anterior  portion  from  Spina 
oss.  Ilei  anter  sup.  and  (three  fourths)  Crista  ilei :  the  posterior 
from  linea  semicircula  superior.  Ins. :  trochanter  major  (from 
the  apex  to  the  base).  Use  :  extends  and  abducts  the  thigh ;  the 
anterior  portion  rotates  it  inwards  (and  helps  to  flex  it). 
Nerves:  glutceus  superior. 

342.  5.  Glutseus  minimus. 

Pos. :  Three-sided ;  covered  behind,  slightly,  by  pyriformis, 
above  by  vasa  glut  sea,  entirely  by  glutseus  med.,  meets  anteriorly 
with  tensor  fasciae,  covers  the  upper  part  of  the  capsule  of  the 
hip  joint.  Or. :  fossa  iliaca  externa  below  linea  semicircul.  in- 
fer.; Crista  Iliaca  (anterior  portion),  incisuraischiadica  (external 
portion).  Ins. :  trochanter  major  (anterior  surface).  Use  :  draws 
the  thigh  directly  outwards ;  the  anterior  portion  rotates  it  in- 
wards, the  posterior  outwards. 

343.  6.  Pyriformis. 

Pos. :  covered  by  glut,  med.,  in  the  incisura  ischiadica  major, 
almost  horizontal  along  the  lower  border  of  glut.  med. ;  in  the 


172  SPECIAL  ANATOMY. 

pelvis,  behind  the  rectum,  Plex.  ischiadic,  Vasa  hypogastrica. ; 
outside,  behind  the  hip  joint;  at  the  superior  border,  Vasa  and 
Nn.  glutdRi. 

NOTE.  The  superior  border  commonly  reaches  the  top  of  the 
incisura  ischiad. ;  between  it  and  the  bone  the  hernia  ischiad. 
passes  through. 

At  the  inferior  border,  Vasa  and  Nn.  ischiatici.  Or.:  1.  Os 
sacrum  (anterior  lateral  surface,  close  to  foramina  sacral,  ant. 
second  and  third,  the  n.  ischiad.).  2.  Lig.  sacro-tuberos. 
(anterior  surface).  3.  Incisura  ischiadica,  superior  part.  Ins. : 
Trochanter  major  (superior  edge  of  the  fossa). 

Nerves  :  glutceus  superior  and  ischiadicus. 

344.  7.  Obturator  internus. 

Pos. :  triangular,  in  the  pelvis,  behind  membrana  obturatoria, 
covered  before  byfasc.  pelvis  and  levator  ani ;  passes  through 
incis.  ischiad,  min.  around  os  ischii  and  horizontally  outwards, 
in  the  groove  between  gemelli,  behind  the  neck  of  the  femur, 
covered  by  glutssus  max.  Or.:  membr.  obturatoria  and  the 
whole  circumference  offoram.  obturatorium.  Ins. :  trochanter 
major,  the  lin.  intertrochant.  post.,  below  pyriformis. 

Nerves:  Ischiadicus. 

345.  8.   Gemellus  superior. 

Pos. :  above  the  tendon  of  the  last  muscle,  horizontally  out- 
wards. Frequently  wanting.  Glutaeus  max.  covers  both  gemelli. 
Or. :  Spina  Ischii  (inferior  border,  external  surface).  Ins.:  like 
the  last  muscle. 

346.  9.   Gemellus  inferior. 

Pos. :  stronger,  below  the  tendon  of  obturator  intern.  Some- 
times double.  Or. ;  Tuber  ischii  (quite  above  lig.  tuber  oso-sacr.) 
Ins. :  like  the  last  muscle.  Uses :  (of  6.  to  9.),  they  rotate  the 
thigh  outwards. 

Nerves:  ischiadicus,  for  8.  and  9. 

347.  10.   Quadratusfemoris. 

Pos. :  transverse,  immediately  below  9. ;  covers  before  obtu- 
rator extern,  and  trochanter  minor ;  between  tuber  Ischii  and 
trochanter  major,  covered  by  Glutseus  max.  Or. :  tuber  ischii 
(external  border)  covered  by  semi-membranos.,  adductor  magnus. 
Ins. :  the  vertical  line  between  basis  trochant.  major  and  linea 
aspera.  Use:  rotates  (even  the  flexed)  thigh  outwards;  rotates 
(when  standing  upon  one  leg)  the  trunk  to  the  other  side. 

Nerves:  ischiadicus. 


THE  MUSCLES.  173 

348.  11.  Obturator  externus. 

Pos. :  behind  the  last  muscle  and  pectinseus,  adductor  brevis, 
psoas  and  iliacus;  before,  for  am.  obturator,  and  collumfemoris; 
meets  above  and  externally,  gemellus  infer.  Or. :  foram.  obtu- 
rator (anterior  circumference).  Ins.:  fossa  of  trochant.  major 
(the  lowest  part).  Use :  rotates  the  thigh  outwards ;  assists  in 
flexing  the  trunk. 

Nerves:  obturator. 

349.  Fascia  iliaca,  s.  lumbo-iliaca, 

envelopes  mm.  psoas  and  iliacus,  arises  from  the  lumbar  portion 
of  the  diaphragm  above,  from  the  bodies  of  the  lumbar  vertebra 
internally,  from  labium  intern.  o£  ilium  and  the  linea  arcuata  of 
the  pelvic  cavity  outwards  as  far  as  crista  pubis.  a.  The  ex- 
ternal portion  divides  between  spina  ilei  ant.  superior,  and  the 
outer  angle  of  the  femoral  ring  into  an  anterior  and  posterior  layer 
(between  which  the  Vasa  circuinflexa  ilei  pass).  1.  The  ante- 
rior layer  turns  upon  the  posterior  surface  of  the  abdominal 
muscles,  and  above  passes  into  ihefasc.  transv.  2.  The  posterior 
layer  unites  with  the  outer  portion  of  lig.  Poupartii  (that  is,fasc. 
ilio-pubica}.  b.  The  internal  portion  descends  over  the  m.  psoas- 
iliacus  upon  the  thigh,  and  unites  externally  \viihfasc.femoris. 

B.  Muscles  of  the  Thigh. 
a.  On  the  posterior  surface. 

350.  1.  Biceps  femo ris  s.  flexor  fibularis. 

Pos.:  on  the  outer  part  of  the  thigh;  its  longhead  covered 
above  by  Glutseus  max.  and  skin ;  lies  upon  the  short  head,  ad- 
ductor magnus,  and  behind  semi-tendinosus ;  the  short  head  on 
vastus  externus,  in  the  lower  half  of  the  thigh,  then  behind  the 
popliteal  vessels.  Forms  the  outer  border  of  the  popliteal  space. 
Or. :  1 .  Caput  long,  from  tuber.  Ischii.  2.  Caput  breve  from  linea 
aspera  oss.  femor.  Ins. :  Capitulum  Jibulse  (and  condylus  ex- 
ternus tibise}.  Use :  flexes  the  leg,  and  accordingly  by  means  of 
the  long  head  it  extends  the  thigh.  The  short  head  rotates  the 
leg  outwards. 

351.  2.  Semitendinosus. 

Pos.':  covers  the  following  muscle  between  it  and  cap.  long, 
bicip.;  its  long  tendon  is,  at  the  commencement,  behind,  then 
between  the  following  muscle  and  gastrocnem.  internus.  The 
tendon  commences  four  or  five  finger  breadths  above  the  knee- 
joint,  winds  around  the  condyl.  intern,  tibise.  forwards,  behind  the 
tendo  sartor.,  on  the  inferior  border  of  tendo  gracilis  ("pes  anse- 


174  SPECIAL  ANATOMY. 

rinus"  tendinosus).  Or. :  tuber  ischii  (united  with  biceps).  Ins. : 
spina  tibiae,  (internal  surface  of  superior  extremity)  and  fasc. 
cruris.  Use :  like  the  last  muscle :  in  semiflexion  it  rotates  the 
thigh  a  little  inwards. 

352.  Semimembranosus. 

Pos. :  before  the  last  muscle,  behind  adduct.  magn.,  gastrocnem. 
intern.,  art.  and  ven.  poplitsea.  Along  the  outer  border,  art.,  ven. 
poplitssa,  nerv.  ischiadicus;  on  the  internal  border,  gracilis. 
Or.:  tuber  ischii  (the  highest,  external  part,  before  biceps  and 
semitendinosus).  Ins.:  Condyl.  intern,  tibise.  Use:  like  the 
last  muscle. 

Nerves :  (first  to  third)  ischiadicus. 

REMARK.  Between  semimembranosus  (within)  and  biceps,  fern,  (without)  a 
longitudinal  space  exists  along  the  whole  posterior  surface  of  the  thigh,  in 
which  the  uniting  tissue  of  the  pelvis,  by  means  of  the  incisura  ischiad.  major., 
communicates  with  that  of  the  popliteal  region. 

b.  Upon  the  outer  surface. 

353.  4.  Tensor  fas cise  latse  (Fascialis). 

Pos. :  in  the  upper  third ;  inside  the  thick  envelope  of  the 
thigh,  on  the  outer  border  of  Sartorius  and  rect.  femor.;  covers 
glut,  med.,  minim.,  and  vastus  extern.  Or. :  Spina  ilei  anter. 
super,  as  far  downwards  as  spina  ilei  infer.  Ins. :  fascia  lata 
femor.  This  is  attached  to  the  coridyl.  extern,  and  Spina  tibix. 
Use  :  maintains  vastus  ext.  in  its  situation;  rotates  inwards,  and 
abducts  the  thigh. 

[Nerve:  Glutceus  superior^ 

c.  On  the  anterior  surface. 

354.  5.  Sartorius  (s.  longus,  because  the  longest  muscle  in 

the  body). 

Pos. :  the  longest  muscle,  Sigmoidal,  from  the  outer  side  of  the 
thigh  to  the  inner  of  the  knee,  under  the  skin ;  forms  at  the  supe- 
rior third  of  the  thigh  with  pectinseus  an  isosceles  triangle  (base, 
above),  in  the  centre  of  which  lies  Art.  cruralis.  In  the  second 
third  Art.  cruralis  at  first  passes  on  the  internal  edge,  then  on 
the  posterior  surface,  and  lastly  on  the  external  edge.  In  the 
last  third  it  lies  between  gracilis  and  vastus  internus  ;  under  the 
anterior  edge  the  n.  saphenus  passes  forth,  on  the  posterior  Ven. 
saphena  (near  the  knee-joint).  Above  between  tensor  fascise  and 
iliacus,  then  upon  rect.  femor.,  adduct.  long.,  vast,  intern,  and 
gracilis.  Or.:  Spina  ilei  anter.  super,  (and  rather  below  this). 
Ins. :  Crista  tibise  labium  internum  (below  Kg.  patellse,  before 
tendd.  mm.  semitendin.  and  gracilis}.  Use  :  flexes  at  the  same 


THE  MUSCLES.  175 

time  thigh  and  leg  (in  squatting)  or  both  alone.     It  only  slightly 
assists  in  crossing  the  legs  (the  position  of  tailors  when  at  work). 

Nerves:  cruralis. 

355.  6.  Extensor  cruris. 

Or. :  see  a.  to  d.  Ins. :  the  tendinous  expansion  around  the 
patella;  tendo  extenso  cruris.  Use:  to  extend  the  leg  or  thigh 
(when  the  one  or  the  other  is  fixed,  as  in  rising  from  the  sitting 
to  the  standing  posture). 

[REMARK.  To  examine  the  insertion  accurately,  make  a  vertical  section  of 
the  tendon,  patella,  and  ligam.  patella  in  the  centre.  TRANS.] 

a.  Rectusfemoris. 

Pos. :  vertical  in  the  centre  of  the  thigh,  between  Spina  ilei 
anter.  super,  and  patella;  above  rather  covered  by  Sartorius,  in 
general  by  the  skin.  Covers  above  the  flexor,  below  the  three 
following  muscles.  Or.:  from  superior  border  of  acetabulum; 
from  Spina  ilei  anter.  infer. 

b.  Vastus  externus. 

Pos. :  behind  the  last,  externally  covered  by  skin,  before  cru- 
ralis. Or. :  trochanter-major  and  labium  externum  linese  asperx 
(superior  half). 

c.  Vastus  internus. 

Pos. :  on  the  inner  part  of  the  thigh,  grooved ;  behind,  the 
inferior  extremities  of  the  adductores  lie  upon  it.  Or.:  from 
labium  intern,  lin.  asperse,  before  m.  adductores  (from  tro- 
chanter  minor]  as  far  as  the  inferior  fourth  of  the  thigh. 

d.   Cruralis. 

Pos.:  close  upon  osfemoris,  surrounded  as  if  in  a  capsule  by 
vastus  externus  and  internus.  Or. :  os  femor.,  close  under 
vastus  intern.,  as  far  as  above  condylus  intern,  femoris.  The 
lowest  fasciculi  have  been  named  Subcruralis. 

Nerves  of  extensor  fern. :  cruralis  (for  vast,  intern.),  besides,  nerv.  obturatorius. 

d.  Internal  surface. 

356.  7.  Gradlis. 

Pos.:  close  under  the  skin,  directly  downwards;  covers  the 
adductores,  below  semitendinos. ;  at  the  inferior  extremity  of  the 
internal  surface  crossed  by  Ven.  saphena  interna.  Or.:  from 
Spina  pubis  ram.  ascend,  oss.  ischii.  Ins. :  Crista  tibise  (within 
and  above),  below  tendo  Sartorii  and  above  tend,  semitendinosi. 


176  SPECIAL  ANATOMY. 

The  long  tendon  winds  around  the  condyl.  intern,  femoris  (and 
tibiae).     Use :  flexes  the  leg,  and  draws  it  inwards. 

Nerves:  obturatorius  (for  the  seventh  to  the  tenth).  [Except  the  eighth. 
—TRANS.] 

357.  8.  Pectinseus  (adductor  superficialis  /.). 

Pos. :  on  the  upper,  anterior  and  inner  part  of  the  femur,  on 
the  inner  border  of  flex,  femoris  (and  Jlrt.  cruralis),  at  the  ex- 
ternal border  of  adductor  longus  ;  before  the  for  am.  obturator, 
m.  obturator  extern.  ( Vasa  obturatoria)  and  articular  capsule ; 
covered  by  fascia  cruralis  and  Vasa  cruralia.  Or. :  Crista 
vubis  (and  a  portion  of  the  fascia  below  lig.  Gimbernati).  Ins. : 
linea  aspera  (two  inches  below  trochanter  minor). 

[Nerve :  Cruralis.     TRANS.] 

358.  9.  Adductor  longus  (superficialis  II. ,  Caput  longum 

tricipitis). 

Pos. :  covered  externally  by  the  last  muscle,  above  by  the  skin, 
below  by  Sartorius,  before  adductor  brevis  and  ma  gnus ;  sepa- 
rated from  Sartorius  by  art.  and  ven.  cruralis.  Or. :  os  pubis 
(between  symphysis  and  crista).  Ins.:  centre  of  linea  aspera. 

359.  10.  Adductor  brevis  (caput  breve  tricipitis). 

Pos. :  covered  by  the  last  muscle ;  at  the  commencement  un- 
covered by,  then  behind  pectinseus.  Or.:  ram.  descend,  oss. 
pubis  (outside  of  gracilis).  Ins.:  linea  aspera  (superior  third). 

360.  11.  Adductor  magnus  (caput.  magnum  tricipitis), 

great  adductor. 

Pos. :  behind  the  two  muscles  last  described  (forms  almost 
alone  the  thick  flesh  on  the  inner  part  of  the  thigh),  before  semi- 
tend.,  biceps,  semimembran.,  glutseus  maximus.  On  the  inter- 
nal border  above,  gracilis;  below,  Sartorius.  At  the  superior 
border  internally,  obturator  extern.;  externally,  quadrat,  fern. 
At  the  inferior  extremity  perforated  by  art.  and  ven.  cruralis. 
Or.:  from  tuber  ischii  to  symphysis  pubis.  Ins.:  the  whole 
labium  extern,  lin.  asperse  to  condylus  internus  femor.  Use: 
eighth  to  eleventh  draw  the  thigh  inwards  (especially  in  riding 
on  horseback) ;  eighth  to  tenth  also  flex  it  a  little. 

Nerve:  Obturator. 


Fascist  femoris  s.  lata, 
arises  from  the  whole  circumference  of  the  outer  surface  of  theN 
Ilium,  envelopes  the   Glutseus  maximus  (fascia  glut  sea),  the 
anterior  and  posterior  surfaces  of  the  thigh ;  consists  on  the  ante- 
rior surface,  of  very  dense  fibres  descending  from  spina  anter. 


THE  MUSCLES.  177 

super,  (that  is,  proper/as  da  lata),  divides,  at  the  internal  border 
of  gracilis,  into  a  superficial  and  deep  layer,  and  unites  with 
fibres  which  are  attached  to  osfemoris.  These  are,  a.  the  superior 
layer  between  ra.  rectus  and  tensor  fascix ;  it  passes  from  the 
anterior  border  of  os  Hei,  anteriorly  above  the  hip-joint  and  neck 
of  the  femur  like  a  ligament,  and  continues  wiih  fascia  lata  below 
the  trochanter  major,  b.  The  external  intermuscular  ligament 
on  the  linea  aspera,  from  trochanter  major  downwards  to  con- 
dylus  externus,  separates  the  flexor  from  the  extensor  muscles 
on  the  outer  side.  c.  The  internal  reaches  from  trochanter  minor 
as  far  as  condylus  intern,  femoris,  is  not  so  strongly  marked, 
separates  vastus  internus  from  adductores. 

362.  Separate  sheaths :   1 .  for  the  femoral  vessels,  vagina 
vasor.  crur.,  a  three-sided  sheath,  between  the  anterior  and  in- 
ternal muscular  sheaths ;  they  help  to  form  the  femoral  canal. 

363.  2.  The  three  great  muscular  sheaths : 

a.  The  posterior,  common  to  m.  biceps,  semi  tendinosus  and 
semi-membranosus. 

b.  The  anterior  divides  into  the  following  sheaths:    1.  For 
Sartorius.     2.  For  rectus  femoris.     3.  For   vast,  extern,  and 
intern.     4.  For  tensor  fasciae. 

c.  The  internal  divides :   1.  For  gracilis.    2.  For  pectin&us  and 
adductor  longus.    3.  For  adductor  brevis  and  obturator  externus. 

364.  3.  The    femoral   ring,  annulus  cruralis,  this  is,  the 
three-sided  opening,  an  inch  and  a  half  broad,  through  which  the 
crural  vessels  pass  out,  behind  ligam.  Poupartii,  from  the  abdo- 
minal cavity  upon  the  anterior  surface  of  the  thigh.     Directed 
obliquely  from  above  downwards  and  from  behind  forwards,  it  is 
bounded  before,  by  the  femoral  arch  (which  supports  the  sper- 
matic cord,   or   round  ligament),  behind,   by  the   horizontal 
ramus  of  the  pubes  (with  m.  pectin,  and  the  deep  layer  of  fascia 
lata),  externally,  by  the  sheath  of  m.  psoas  and  iliacus ;  here  the 
vasa  epigastrica   ascend.     Its   posterior   angle   corresponds    to 
eminent,  ileo-pectinasa  ;   between  flexor  femor.   and  pectineus. 
Its  external  angle  arises  from  the  junction  of  the  lig.  Poupartii 
with  the  sheath  of  the  Psoas,  in  which  lies  nerv.  cruralis.     The 
lig.  Gimbernati  forms  the  internal ;  it  is  obtuse,  in  the  normal 
course  of  the  art.  obturator  free  from  vessels,  but  between  V. 
cruralis  and  lig.  Gimbernati  a  large,  deep  inguinal  gland  lies. 
(Hernia  cruralis  passes  out  at  this  point.)     Towards  the  abdo- 
minal cavity  the   crural  ring  is   covered  by  loose  uniting  tissue 
(septum  crur  ale}. 

365.  4.  Femoral  canal,  canalis  cruralis,  is  the  excavated 
12 


178  SPECIAL  ANATOMY. 

space,  which  reaches  from  the  femoral  ring  as  far  as  to  the  spot 
where  the  anterior  layer  of  the  three-sided  sheath  of  the  Vasa 
cruralia  commences ;  it  consists  of  a  three-sided  fossa  (fossa 
ileo-pectinea),  between  m.  pectinem  (internally)  and  psoas  (ex- 
ternally), which  by  an  incomplete  anterior  wall,  the  tendinous 
proc.  falciformis,  is  formed  into  a  canal.  It  goes  downwards 
and  inwards,  is  on  the  outer  side  an  inch  and  a  half,  on  the  inner 
half  an  inch  long.  The  superior  border  of  proc.  falciform. 
attaches  itself  to  Kg.  Poupartii,  and  reaches  as  far  as  lig.  Gim- 
bernati ;  here,  at  the  free,  crescentic,  internal  border  of  proc. 
falciform,  is  a  large  anterior  interval,  oval  fossa  (fossa  ovalis), 
through  which  V.  saphena  interna  (and  the  place  at  which  the 
hernia  cruralis  generally)  passes  ;  it  is  covered  by  the  superficial 
layer  of  fasc.  superfic.  (here  lamina  cribrosa,  on  account  of  the 
numerous  openings  for  vessels,  nerves,  and  lymphatic  glands), 
superficial  inguinal  glands,  and  skin.  The  femoral  canal  termi- 
nates below  in  a  small  opening,  at  the  entrance  to  the  sheath  of  the 
vasa  cruralia. 

C.  Muscles  of  the  Leg. 
a.  On  the  anterior  surface. 

366.  1.   Tibialis  anticus  s.  hippicus. 

Pos. :  beneath  the  skin,  along  the  outer  surface  of  the  tibia; 
close  to  it  on  the  outer  side :  extens.  digitor.  ped.  commun.  and 
(below)  propr.  hallucis  (separated  from  Vasa  and  Nn.  tibiales 
antici).  Or. :  the  two  upper-thirds  of  the  outer  surface  of  the 
tibia;  the  ligam.  interosseum.  Ins.:  Os  cuneiforms  I.  and 
basis  oss.  I.  metatarsi  (internal  surface) ;  projecting  strongly. 
The  tendon  passes  over  the  inferior  extremity  of  the  tibia  to- 
wards the  inner  side  of  the  foot.  Use  :  flexes  the  foot,  that  is  to 
say,  approximates  the  back  of  the  foot  to  the  leg,  and  rather 
raises  the  inner  border  of  the  foot. 

367.  2.  Extensor  hallucis  longus. 

Pos. :  between  1.  and  2. ;  external  to  tibial.  antic. ,  separated 
from  it  behind  by  Vasa  and  N.  tibial  ant. ;  on  the  outer  side  of 
its  tendon :  art.  pedisea.  Or. :  internal  to  and  behind  the  last 
muscle,  from  the  centre  of  the  inner  surface  of  the  fibula  and 
from  Kg.  interosseum.  Ins. :  Basis  Phalangis  II.  hallucis. 
The  tendon  passes  at  a  right  angle  over  the  dorsum  of  the  foot 
upon  the  first  metatarsal  bone.  Use  :  extends  both  phalanges  of 
the  great  toe,  flexes  and  raises  the  inner  border  of  the  foot  a  little. 

368.  3.  Extensor  digitorum  communis  longus. 

Pos. :  beneath  the  skin,  between  tibial  ant.  and  extens.  halluc. 


THE  MUSCLES.  179 

long,  (internally),  and  peronseus  long.,  and  brevis  (without), 
covers  \hefibula,  lig.  inteross.,  artic.  tibio-tarsalis,  m.  pediasus, 
and  the  toes.  Or. :  condylus  externus  tibiae :  inner  surface  of 
fibula,  (four-fifths ;)  lig.  mterosseum.  Ins. :  Phalanx  II.  and 
///.  of  the  second  to  the  fifth  toe.  Each  of  the  four  tendons  is 
fissured  into  three  portions,  the  two  lateral  of  which  go  to  the 
third  phalanx,  the  central  to  the  basis  of  the  second  phalanx. 
Use :  extends  the  third  phalanx  of  the  second,  third,  fourth,  and 
fifth  toes. 


3.  Peronseus  anticus  s.  tertius. 

Pos. :  on  the  outer  side  of  the  anterior  surface  of  the  leg  (infe- 
rior third) ;  between  3.  and  peronseus  brevis.  Or. :  inferior  half 
of  fibula  (anterior  internal  surface).  Ins.:  Basis  oss.  V.  meta- 
tarsi. The  tendon  passes  obliquely  outwards  under  lig.  crucial., 
over  the  back  of  the  foot.  Use :  to  flex  the  foot,  and  raise  it 
rather  outwards. 

Nerves  for  1.  to  4. :  peroneus  proftmdus  [tibialis  ant.]. 

b.  On  the  outer  surface. 

370.  5.  Peronseus  longus  (s.  primus). 

Pos.:  under  the  skin  of  the  peronaeal  region,  along  the  fibula; 
in  front,  separated  by  a  fascia  from  extens.  digitor.  longus,  be- 
hind and  above  from  soleus,  below  from  flex,  halluc.  long.; 
covers  peronsens  brevis  externally.  In  the  foot  the  tendon  lies 
between  skin  and  os  calcanei,  in  the  sole  it  is  covered  by  the  soft 
parts.  Or. :  capitulum  and  superior  third  of  external  surface  of 
fibula  (by  two  heads) ;  the  inferior  as  low  as  the  inferior  fourth. 
Ins. :  Basis  oss.  I.  metatarsi.  Its  tendon  passes  round  the  ex- 
ternal malleolus,  in  a  groove  (also  with  the  following  muscle), 
curves  forwards  and  downwards  to  the  outer  border  of  calcaneus, 
and  passes  once  again  curved  in  the  groove  of  the  os  cuboid,  ob- 
liquely forwards  and  inwards  into  the  sole  of  the  foot,  to  the  first 
cuneiform  and  first  bone  of  metatarsus.  Use :  extends  the  foot  and 
draws  the  external  border  outwards  and  upwards.  (In  fractures 
of  the  fibula  the  talus  therefore  passes  inwards — the  outer  mal- 
leolus more  prominently  outwards — dislocation  inwards.) 

371.  6.  Peronseus  brevis  (s.  secundus). 

Pos. :  under  the  last  muscle,  covers  fibula  above,  on  the  ante- 
rior, below,  on  the  posterior  angle,  in  the  centre  upon  the  outer 
surface.  Before  it  peron.  3.,  behind  it  peron.  long,  and  flexor* 
hallucis  long.  Or. :  external  surface  of  the  fibula  (inferior  third). 
Ins. :  the  tendon  passes  forwards  in  the  groove  of  the  external 
malleolus  upon  the  calcaneus,  over  tendo.  peron.  longi  and  o* 


180  SPECIAL  ANATOMY. 

cuboid,  to  the  dorsal  surface  and  tubercul.  metatarsi  5.  Use : 
extends  and  draws  the  foot  outwards;  abducts  somewhat  the 
little  toe. 

Nerves  for  5.  to  6.:  peron&us. 

C.  On  the  posterior  surface, 
a.  Superficial  layer. 

372.  7.   Gastrocnemius  s.  gemetti  surse. 

Pos. :  above,  by  its  two  heads,  it  bounds  the  popliteal  region, 
.forms  the  posterior  thick  flesh  of  the  calf,  close  under  the  skin; 
the  external  head  covered  by  biceps,  the  internal  by  semitendinos. 
Or. :  1.  The  external  head  from  condylmfemor.  extern,  (gemell. 
extern.}  2.  The  internal  head  from  condylus  intern,  (gemellus 
intern,  stronger.)  Both  heads  unite  in  the  form  of  the  letter  V. 
Ins. :  Undo  Jlchillis  (to  tuber  calcanei).  Use  :  to  extend  the  foot, 
rather  flexing  the  leg. 

373.  8.  Plantaris  (in  man  rudimentary,  often  wanting). 
Pos. :  above  and  to  the  inner  side  of  the  external  head  of  the 

last  muscle  passing  between  soleus  and  gemell.  intern.  Its  long 
tendon  first  between  Gastroc.  and  Soleus  lies  on  the  inner  side 
of  tendo  JLchillis.  Or. :  condylus  externus  femoris  (from  cap- 
sular  ligament),  connected  with  gemell.  extern.  Ins.:  tuber 
calcanei  (before  or  close  to  the  tend.  ^.chill.). 

374.  9.  Soleus. 

Pos. :  covered,  particularly,  by  gemell.  intern,  behind ;  before 
\)jjlex.  digit  commun.  and  hallucis  propr.,  tibial  postic.,  Vasa 
and  Nn.  tibial.  postic.  and  Jibulares.  Or.:  1.  tibiae  lin.  obliq. 
poster,  (under  poplit&us).  2.  Capitul.fibulse  (posterior  surface). 
Ins.:  tendo  ^.chillis.  This  arises  from  the  junction  of  the  ten- 
dons of  7.,  8.,  and  9.;  is  one  and  a  half  to  two  inches  long,  is 
fixed  broad  to  the  posterior  surface  of  tuberc.  calcanei,  and  lies 
in  a  double  sheath ;  the  external  is  thick  and  red,  the  internal, 
thin,  colourless,  and  more  tense.  Use:  7.  to  9.  extend  the  foot; 
8.  extends,  in  the  lower  animals,  the  fascia  plantaris. 

b.  Deep  layer. 

375.  10.  Poplitseus. 

Pos. :  small,  thin,  triangular,  oblique  from  without,  downwards 
and  inwards  upon  the  knee  joint,  covered  by  plantaris  and  gas- 
trocnemius,  separated  by    Vasa  poplit.   and  n.  poplit.  intern 
Or.:  fossa  behind  [at  the  side  of]  condyl.  extern,  femoris  (under 
m.  gemellus.  extern.).     Ins.:  the  triangular,  posterior  (and  supe- 


THE  MUSCLES.  181 

rior)  surface  of  tibia.  Use  :  to  flex  the  leg  and  roll  it  somewhat 
inwards. 

376.  11.   Tibialis  posticus  s.  nauticus. 

Pos. :  the  deepest,  between  tibia  and  fibula  upon  Kg.  inter- 
osseum,  covered  by  flexor  commun.  long.,  hallitc.  propr.  and 
soleus.  Its  tendon  in  front  of  that  of  the  flex.  comm.  longus, 
goes  under  the  internal  malleolus.  Or.:  tibia  (posterior  surface), 
fibula  (internal  angle),  lig.  interosseum.  Ins. :  tuber  oss.  navi- 
cularis  (inner  border) ;  and  with  aponeurotic  appendages  to  oss. 
cuneiform.  2.  and  3.  Use :  extends  the  foot,  rotates  the  sole 
inwards. 

377.  12.  Flexor  digitorum  communis  long.  s.  perforans. 
Pos.:  the  most  internal,  along  the  posterior  surface  of  the  tibia 

and  sole  of  the  foot,  penniform ;  between  tibial.  post,  and  tibia, 
covered  above  by  soleus,  behind  Vasa  and  Nn.  tibiales  postici. 
Or.':  linea  obliq.  tibise  (under  m.  poplit.  and  soleus},  and  three- 
fifths  of  the  centre  of  the  Tibia  (posterior  surface).  Ins.  :  Basis 
phalang.  III.  of  the  second  to  the  fifth  toe  (plantar  surface). 
The  tendon  lies :  on  the  internal  malleolus  behind  that  of  the 
tibial  post.,  on  the  inner  border  of  the  foot  rather  externally; 
passes  between  colds  and  abductor,  halluc.  long,  into  the  sole 
of  the  foot:  in  the  metatarsus  upon  the  inter ossei.  Use  :  flexes 
the  four  outer  toes,  and  after  that  extends  the  foot. 

REMARK.     Pulleys  and  tendinous  sheaths  like  the  flexors  of  the  fingers. 

378.  13.  Flexor  halluds  longus. 

Pos.:  the  most  external  and  strongest,  covered  behind  by  soleus 
and  tendo  Acli.  behind  fibula,  tibial.  post,  and  Art.  peronsea, 
(below)  lig.  inteross.  On  the  outer  border:  peron.  long,  and 
brev. ;  on  its  inner  border :  flex,  communis  Ion g.  The  tendon 
curves  towards  the  sole,  passing  obliquely  over  ihefiex.  commun. 
long.  Or. :  fibula  (posterior  internal  surface  from  the  two  in- 
ferior thirds).  Ins.:  Basis  phalang.  II.  halluds  (plantar  sur- 
face) united  (by  fascia)  with  the  last  muscle.  Use :  to  flex  the 
second  phalanx  of  the  great  toe ;  assists  (when  the  foot  is  raised) 
to  extend  the  foot. 

pn  the  sole  of  the  foot  the  tendon  of  this  muscle  is  connected,  by  a  ten- 
dinous slip,  with  that  of  the  last.] 

Nerves  for  7.  to  13. :  tibialis.  . 

379.  Fasda  s.  vagina  cruris. 

Invests  only  those  parts  of  the  leg  covered  by  muscles,  is  con- 
nected above  and  behind  with  the  fascia  femoris,  strengthened 
by  tendinous  expansions  from  the  biceps,  sartorius,  gradlis, 


182  SPECIAL  ANATOMY. 

semitendinosus  ;  above  and  before,  in  front  of  the  Patella,  like- 
wise with  the  fasc.  femoris,  below  with  the  ligaments  of  the  bend 
of  the  ankle.  Its  external,  cutaneous  surface  forms  a  sheath  for 
vena  and  nerv.  saphsen.  extern. ;  the  internal  attaches  itself  to 
the  crista  tibiae  and  fibulae,  and  forms  three  principal  sheaths  for 
the  anterior,  external  and  posterior  muscles,  and  several  second- 
ary sheaths  (e.  g.,  between  the  superficial  and  deep  layer  on  the 
posterior  surface).  On  the  malleoli  it  forms  the  following  liga- 
ments : 

380.  1.  Lig.  transversum,  an  inch  and  a  half  broad,  passes 
from  the  anterior  angle  of  the  tibia  to  that  of  the  fibula,  and 
covers  the  inferior  portion  of  the  muscles. 

381.  2.  Lig.  cruciatum  tarsi,  consists  of  striae  one  half  to  one 
inch  broad,  crossing  over  the  tarsal  joint,    a.  The  superior  passes 
from  the  internal  malleolus  to  the  superior  and  outer  surfaces  of 
proc.  anter.  calcanei,  developes  two  tendinous  sheaths,  an  internal 
(for  tibial.  antic.),  an  external  (for  extens.   digit,   comm.  long. 
and  peron.),  and  a  central,  incomplete,  for  extens.  halluc.  long. 
and  Vasa  and  Nn.  tibiales  antici.)    Retzius  describes  underneath 
a  sling-shaped  ligament,  lig.  fundiforme  tarsi,  which  lies  in  a 
crescentic  form  over  the  tendon  of  extens.  commun.  long,  and 
peronseus  tertius.    b.  The  inferior,  from  the  external  malleolus 
to  the  internal  border  of  the  foot,  continues  into  the  aponeurosis 
plantar,  (interna),  and  forms,  likewise,  upon  the  back  of  the 
foot,  sheaths  for  the  before-described  muscles. 

382.  3.  Lig.  laciniatum  tarsi  intern.,  from  the  inner  malleo- 
lus to  the  inner  side  of  Calcaneus,  forms  four  sheaths :  a.  for 
art.,  ven.,  and  n.  tibial.  post,  (the  most  superficial) ;  b.  for  m. 
tibial  postic.  (the  anterior) ;  c.  m.  fiex.  digit,  comm.  long,  (the 
posterior).      Both  behind  the  malleolus  intern.  ;  d.  for  m.  fiex. 
hallucis  long,  (the  most  inferior). 

383.  4.  Lig.  laciniatum  tarsi  externum,  from  the  external 
malleolus  to  the  calcaneus,  forms  at  the  commencement  a  common 
sheath,  afterwards  divided  into  two,  for  m.  peronseus  longus  and 
brevis. 

D.  Muscles  on  the  Foot, 
a.  Upon  the  dorsum  of  the  foot. 

384.  1.  Extensor  digitorum  brevis  s.  pediseus. 

Pos. :  oblique  from  without,  inwards,  and  from  behind,  for- 
wards, under  the  tendons  of  the  long  extensor  of  the  toes,  over 
the  anterior  row  of  the  tarsal  and  metatarsal  bones.  On  the  inner 
border:  Art.  pedisea.  [extens.  hallucis  brevis  is  the  strongest]. 
Or.:  Proc.  anterior  calcanei  (external  surface).  Ins.:  Phalanx  I. 
of  the  first  to  the  fourth  toe,  on  the  external  border  of  the  long 


THE  MUSCLES.  183 

extensor  of  the  toes  and  the  extern,  hattuds.    Use :  extends  the 
first  phalanx  of  the  four  inner  toes. 
Nerves :  peronaus  profumdus  [tibial.  ant.~\. 

b.  On  the  internal  region  of  the  sole  of  the  foot. 

a.  Attached  to  the  inner  surface  of  the  first  phalanx  of  the 

great  toe. 

385.  2.  Abductor  hallucis. 

Pos. :  on  the  internal  border  of  the  foot,  beneath  the  skin, 
under  the  flexor  muscles  of  the  great  toe,  on  the  outer  border  of 
flex,  halluc.  and  communis  brevis.  Or. :  1.  The  long  (posterior) 
head  from  the  posterior  and  inner  surface  of  the  tuber  calcanei. 
2.  The  short  head  from  os  cuneiforme  I.  and  fasc.  plantaris. 
Ins. :  Os  sesamoideum  on  the  basis  of  first  phalanx  of  great  toe. 
Use :  to  draw  the  great  toe  from  the  second,  and  flex  it. 

386.  3.  Flexor  hallucis  brevis. 

Pos.:  on  the  first  os  metatarsi,  between  abductor  and  ad- 
ductor. Or. :  Os  cuboideum  and  os  cuneiforme  III.  Ins. :  Os 
sesamoideum  internum.  Use :  flexes  the  first  phalanx  of  great  toe. 

/3.  Attached  to  the  external  surface  of  the  first  phalanx  of  the 
great  toe. 

387.  Adductor  hallucis. 

Pos. :  strong,  triangular,  in  the  concavity  between  the  second 
and  fifth  os  metatarsi,  above  flexor  longus,  lumbricales,  under 
interossei  and  Jirt.  plantar,  externa;  on  its  inner  border:  tendo 
peronsei  longi  and  flex,  halluc.  brevis.  Or.:  1.  Os  cuboideum 
\viih  flex,  hallucis  brevis.  2.  Tendo  peronsei  longi,  oblique  to 
the  insertion:  into  Os  sesamoideum  externum.  Use:  draws  the 
great  toe  outwards  towards  the  centre  of  the  foot,  and  flexes  it. 

388.  5.   Tr  ansver  salis  pedis  (s.  adductor  transversus). 
Pos. :   small,  and  transverse  between  os  metatars.  IV.  and 

hallux  in  the  anterior  part  of  the  concavity  of  the  metatarsus, 
above  lumbricales,  under  interossei;  is  the  anterior  short  head 
of  the  last  muscle.  Or. :  Capitul.  oss.  metat.  IV.  and  V.  Ins. : 
Os  sesamoideum  externum.  Use :  approximates  the  great  to  the 
little  toe,  making  the  sole  hollow  (like  771771.  opponentes  of  hand). 

c.  On  the  outer  region  of  the  sole  of  the  foot. 

389.  6.  Mductor  digiti  minimi. 

Pos. :  close  above  fasc.  plantar,  extern.,  under  the  following 
muscle  ;  on  the  outer  edge  of  the  foot.  Or. :  tuber,  extern,  cal- 
canei and  aponeur.  plantar,  ext.  Ins. :  Basis  phalang.  I.  of  the 


184  SPECIAL  ANATOMY. 

fifth  toe  (outer  side).     Use:  draws  the  fifth  toe  from  the  fourth, 
and  rather  flexes  it. 

390.  7.  Flexor  brevis  digiti  minimi  (s.  interosseus  V.}. 

Pos. :  on  the  outer  border  of  os  metatars.  V.,  above  the  ten- 
don of  the  last.  Or. :  1.  Lig.  calcaneo-cuboid.  2.  Basis  oss. 
metatars.  V.  Ins. :  Basis  Phalang.  I.  of  fifth  toe  (plantar  sur- 
face). Use :  draws  the  outer  border  of  the  foot  downwards  and 
inwards ;  rather  flexes  the  first  phalanx  of  the  fifth  toe. 

d.  In  the  centre  of  the  sole  of  the  foot. 

391.  8.  Flexor  digitorum  brevis  s.  perforatus. 

Pos. :  close  above  fascia  plantar.,  under  Vasa  and  Nn.  plan- 
tar., tendo  flex,  long.,  muse,  accessor.,  lumbrical.  Or. :  from 
tuber  intern,  calcanei,  and  fasc.  plantar,  (centre).  Ins. :  each 
of  the  four  tendons  (perforated  by  flexor  long.}  passes  divided  to 
the  borders  of  the  second  phalanx  of  the  second  to  the  fifth  toe. 
Use :  to  flex  the  second  phalanx  of  the  second,  third,  fourth,  and 
fifth  toes. 

392.  9.   Quadratus  plant  as  s.  Caro  quadrat  a   Sylvii  s. 

musculus  accessorius. 

Pos. :  above  the  last  muscle,  the  vessels  and  nerves  of  the  sole 
of  the  foot ;  under  Calcaneus  and  Kg.  calcaneo-cuboid.  infer. 
Or. :  1.  Groove  upon  the  under  surface  of  Calcaneus.  2.  Lig. 
calcaneo-cuboideum.  Ins. :  the  external  border  and  the  inferior 
surface  of  the  tendon  of  m.  flexor,  comm.  longus.  Use:  assists 
in  flexion,  and  draws  the  tendons  of  flexor  longus  outwards. 

393.  10.  Lumbricales  IV. 

Pos.:  on  the  inner  border  of  the  tendons  of  flexor  digitor. 
longus.  Or. :  the  angle  of  division  of  the  tendons  of  flexor 
digit,  long,  (inner  edge).  Ins. :  Basis  phalang.  I.  of  second  to 
the  fifth  toe.  Use  :  to  flex  the  first  phalanx  of  the  second,  third, 
fourth,  and  fifth  toes. 

394.  11.  Inter ossei  interni  plantar es,  4. 

Pos. :  between  the  metatarsal  bones  of  the  first  to  the  fifth 
toe  ;  covered  by  the  following  muscles.  Or. :  the  internal  (tibial) 
side  of  the  second  to  the  fifth  os  metatars.  Ins. :  first  phalanx 
of  the  second  to  the  fifth  toe  (tibial  side).  Use  :  to  draw  the  four 
outer  toes  inwards  towards  the  first. 

395.  12.  Interossei  externi  s.  dorsales,  3. 

Pos. :  between  the  metatarsal  bones  of  the  second  to  the  fifth 
toe ;  perforated  at  the  posterior  extremity  by  Jlrtt.  perforantes. 


THE  MUSCLES.  185 

Or. :  by  two  heads  from  the  surfaces  of  two  metatarsal  bones  as 
they  are  turned  to  one  another.     Ins. :  the  fibula  (external)  bor- 
der of  the  second  to  the  fourth  toe.     Use:    to  draw  the  four 
outer  toes  from  the  great  toe. 
Nerves  for  2.  to  12.:  plant aris  extern,  et  internus. 

396.  Fasciae  musculares  pedis. — z.fasc.  dorsalis,  a  thin  mem- 
brane which,  commencing  behind  from  the  fascia  cruris,  covers 
the  back  of  the  foot,  in  front  on  the  first  phalanx  of  the  toes 
passing  over  into  the  sheaths  of  these,  and  at  the  sides  into  the 
fascia  plantaris  ;  a  superficial  layer  covers  the  tendons  of  extens. 
digit,  longus  ;  a  central  the  extens.  digit,  brevis  (before) ;  a  deep 
the  interossei. — b.  Aponeurosis  plantains,  a  thick,  shining  mem- 
brane, which  commences  behind  on  the  tuber  Calcanei,  at  first 
narrow,  then  broader,  terminating  in  the  region  of  the  anterior 
extremities  of  the  metatarsal  bones  in  four  lappets,  laciniss  plan- 
tares,  which  are  divided,  and  form  four  sheaths  for  the  tendons 
of  the  flexor  muscles  of  the  second  and  four  outer  toes.     These 
sheaths  are  separated  by  three  arches,  under  which  the  mm.  lum- 
bricales  and  interossei  and  the  plantar  vessels  and  nerves  pass 
away.     The  borders  curve  round  from  above  and  below,  sur- 
round the  flexor  digitor.  brevis,  and  form  septa  between  the 
muscles  of  the  centre  and  the  outer  and  inner  region  of  the  sole 
of  the  foot.     Externally  an  apon.  plantaris  externa  (attachment 
of  M.  abduct,  digiti  minimi}  passes  off,  which  is  attached  in 
front  to  the  basis  oss.  metatarsi  V.,  and  forms  a  sheath  for  ab- 
ductor zndfiexor  brevis  digiti  V.     Internally  a  thinner,  f.  plan- 
tar, intern.,  which  commences  behind  between  Malleolus  intern. 
and  Calcaneus,  is  attached  to  the  inner  border  of  the  Tarsus,  and 
forms  a  tendinous  sheath  for  flexor  and  abductor  brevis  hallucis, 
and  art.  and  ven.  plantar,  intern.     The  central  sheath  encloses : 
M.  flexor  digitor.  brevis,  tendo  m.  flexor  digitor.  and  hallucis 
longus,  Caro  quadrata  Sylvii,  lumbricales,  adductor  hattuc.  and 
transversal,  pedis,  Vasa  and  nerv.  plantares  externi.  Mm.  inter- 
ossei lie  in  separate  sheaths. 

c.  The  ligaments  and  sheaths  of  the  toes  are  analogous  to  those 
of  the  fingers. 

Summary  of  the  Actions  of  the  Muscles. 
I.  Head. 

397.  A.  The  whole  head,  the  neck  being  fixed,  moves : 

a.  Forwards  (flexion) :   Sterno-cleido-mast.,  rectus  capitis  an- 
ticus  of  both  sides. 

b.  Backwards  (extension) :  cucullaris,  splenius  capit.,  biv enter 


186  SPECIAL  ANATOMY. 

and  complexu,s  cervicis,   trachelo-mastoid.,  rectus  postic.  and 
obliq.  sup.  of  both  sides. 

c.  Sideways :  sterno-cleido-mast.,  rectus  capit.  lateralis,  sple- 
nius  capit.,  trachelo-mast.,  obliq.  capitis  super,  of  one  side. 

d.  The  head  rotates  sideways  at  the  same  time  with  the  At- 
las :  splenius  capitis,  trachelo-mast.,  obliq.  cap.  infer,  of  the  one 
and  sterno-deido-mast.  of  the  other  side. 

398.  B.  The  skin  moves  upon  the  skull: 

a.  Forwards :  frontales,  which  at  the  same  time  put  the  skin 
of  the  forehead  into  transverse  wrinkles. 

b.  Backwards :  occipitales,  which  at  the  same  time  make  the 
skin  of  the  forehead  smooth. 

399.  C.  The  ear  is  drawn: 

a.  Upwards :  attollens  ;  forwards :  attrahens  ;  backwards  :  re- 
trahentes. 

400.  D.  The  eye: 

a.  The  eyebrow  is  drawn  inwards  and  downwards  with  lon- 
gitudinal wrinkles :  corrugator  superc. 

b.  The  fissure  between  the  lids  contracted  and  closed  by: 
sphincter  palpebr. 

c.  The  upper  lid  raised :  lev ator  palpebr.  super.,  by  which  the 
skin  passes  backwards. 

d.  The  globe  of  the  eye  is  directed  outwards,  inwards,  up- 
wards, downwards :  recti. 

e.  The  same  is  rotated  upwards  and  inwards :  obliq.  super. ; 
downwards  and  outwards  :  obliq.  infer. ;  upwards  and  outwards : 
obliq.  infer,  and  rect.  extern,  together. 

401.  E.  The  nose: 

a.  Is  drawn  down  and  the  nasal  openings  contracted  by  :  de- 
pressor alas  and  compressor. 

b.  Drawn  outwards  and  widened  by  :  dilatator  posterior  and 
anterior. 

c.  Turned  up  by:  levator  al%  et  labii  (s.  pyramidalis). 

402.  F.  The  mouth: 

a.  The  fissure  of  the  mouth  is  shortened   and   closed:    by 
sphincter  oris. 

b.  The  angle  of  the  mouth  is  drawn  downwards   and  back- 
wards, by  which  the  cheeks  are  pressed  against  the  rows  of  teeth 
(as  in  mastication)  and  the  cheeks  are  expanded  (as  in  blowing 
and  whistling) :  buccinator. 

Upwards  by :  lev.  anguli  oris  and  zygomat.  major. 


THE  MUSCLES.  187 

Downwards  (it  is  pretended)  by:  triangular^  with  transv. 
menti. 

c.  The  upper  lip  is  raised  by :  levator  labii,  alx  nasi  et  labii 
super.,  zygomatic.  minor. 

d.  The  under  lip  drawn  downwards  and  everted  by :  quadra- 
tus  menti.     It  is  raised,  when  the  skin  of  the  chin  is  stretched, 
by :  levator  menti. 

403.  G.  The  lower  jaw  is : 

a.  Drawn  downwards  by:  digastric,  maxill.,  mylo-,  genio- 
hyoidei. 

b.  Drawn  upwards  by :  masseter^tevnporalis^pterygoideus  in- 
ternus. 

c.  Pushed  forwards  and  to  the  opposite  side  by :  pterygoideus 
externus. 

404.  H.  The  soft  palate  is: 

a.  Raised  and  stretched  transversely  by :  levator  palati  mollis  ; 

b.  Depressed  (thereby  elongated  and  stretched)  by :  pharyngo- 
palatin.,  glosso-palatinus. 

c.  Shortened  (the  uvula  thereby  elevated  and  curved  back- 
wards) by:    azygos  [J,evatores~]  uvulse. 

d.  Stretched  (it  is  pretended)  by:  circumflex,  palati  mollis. 

405.  I.  The  Pharynx  is  : 

a.  Contracted  by :  three  constrictores  pharyngis. 

b.  Raised  and  widened  by:  stylo-pharyng.,  salpingo-pharyn- 
geus. 

406.  K.  The  os  hyoides  is : 

a.  Raised   forwards  by:   digastricus   (anterior  belly),  mylo- 
hyoideus,  genio-hyoideus. 

b.  Backwards  by:  stylo-hyoid.,  digastricus  (posterior  belly). 

c.  Drawn  downwards  by :  o?no-,  sterno-hyoideus,  hyo-thyreoi- 
deus. 

407.  L.  The  tongue  is : 

a.  Compressed  against  the  floor  of  the  mouth  by:  genio-,  hyo- 
glossi. 

b.  Base  and  borders  raised  backwards  by :  stylo-glossi. 

c.  Shortened,  and  the  apex  curved  upwards  and  backwards, 
by:  lingualis  superfic.;  shortened,  and  the  apex  curved  down- 
wards, by:  lingual  inferior;  diminished,  elongated,  and  rounded 
at  the  apex,  by :  lingual  transversus. 

408.  M.  The  larynx  is: 

a.  Drawn  downwards  (trachasa  shortened)  by :  sterno-thyreoi- 
deus. 


188  SPECIAL  ANATOMY. 

b.  Drawn  upwards,  towards  the  os  hyoides  (Epiglottis  curved 
backwards),  by :  hyo-thyreoid. 

c.  The  epiglottis  bent  back  (and  the  entrance  shut)  by :  reflect- 
or epiglottidis. 

d.  The  vocal  cords  removed  from  one  another,  and  the  entrance 
widened  by :  crico-arytaenoideus  posticus. 

II.  Trunk. 

409.  A.  The  neck  is : 

a.  Flexed  by:  longus  colli  and  scaleni  (3)  of  both  sides. 

b.  Extended  by:   splenius   colli,  transversal,  (and  spinales, 
semi-,  inter-spinales,  multifidi). 

c.  Drawn  sideways  by :  transversal.,  cervical,  descend.,  spinalis 
and  semispinalis  cervicis,  obliq.  capit.  infer,  (on  the  atlas),  in- 
tertransv.  and  multifid.,  scalenus  med.  afid  post,  of  one  side. 
Rotated  by:  splen.  colli.,  transversal.,  cervicalis  of  the  other. 
The  skin  of  the  neck  is  moved  by :  platysmamyoides. 

410.  B.  Thorax.    1.  The  thoracic  portion  of  the  vertebral 
column  is: 

a.  Flexed  by:  recti,  obliq.  and pyramidales  abdominis. 

b.  Extended  by:  multifidi,  inter spinal es,  spinales  and  semi- 
spinal,  dorsi,  sacro-lumbales  and  longissim.  dorsi. 

c.  Drawn  sideways  by :  multifidus  on  one  side ;  rotated  by : 
rotatores  dorsi  and  multifidus  of  one  side. 

411.  2.  The  ribs  are: 

a.  Elevated  and  the  chest  widened  as  the  lungs  expand,  and 
the  diaphragm  contracts  downwards  (descends)  by:  intercostales, 
levatores  costarum,  scaleni  (they  fix  the  first  ribs),  serratus  pos- 
ticus superior.     As  in  inspiration. 

NOTE.  Deep  inspiration  is  effected  by  sterno-cleidomast.,  subdavius,  pectorales, 
serratus  anticus,  latissim.  dorsi,  cervicalis  descend.  The  intercostales  (and  infra- 
costales)  approximate  the  ribs,  since  they  draw  them  up  wards  (inspiration)  or 
downwards  (expiration). 

b.  Drawn  downwards  by :  intercostales,  serratus  post,  inferior, 
triangularis  sterni,  quadratus  lumborum  (fixes  the  twelfth  rib), 
abdominal  muscles.     As  in  expiration. 

412.  3.  The  sternum  is  : 

a.  Drawn  up  by:  s'terno-cleido-mast.,  sterno-hyoidd. 

b.  Downwards  by :  recti  abdominis. 

413.  C.  The  lumbar  portion  of  the  vertebral  column  is : 

a.  Flexed  by:  psoas  major  et  minor  of  both  sides. 

b.  Extended  by :  longissim.  dorsi,  ileolumbalis. 


THE  MUSCLES.  189 

c.  Inclined  sideways  by:   quadrat,  lumbor.,  multifidus  and 
inter-transversarii  of  one  side. 

414.  D.  The  coccyx  is  : 

a.  Flexed  by :  sacro-coccygeus  anticus,  coccygeus;  levator  ani. 

b.  Extended  by :  sacro-coccygeus  posticus. 

415.  E.  The  pelvis  is  drawn  and   rotated  forwards,  back- 
wards, and  sideways  by  the  flexors,  extensors,  and  rotators  of  the 
thigh. 

a.  The  anus  is  closed  by :   Sphincter  ani  ;  anus  and  prostate 
elevated  by  :  levator  ani. 

b.  The  urethra  is  compressed  by  :  constrict,  isthmi  urethr. ; 
the  corp.  cavernosa  by :  erector  penis  ;  the  bulb  by :  bulbo-caver- 
nosus. 

c-  The  bladder  is  drawn  down  by:  the  vesicalis ;  the  vagina 
contracted  by :  constrictor  vaginas. 

d.  The  testes  raised  towards  the  external  abdominal  ring  by : 
cremaster. 

III.  Superior  Extremity. 

416.  A.  The  clavicle  is  : 

a.  Raised  by  :  cucullaris,  cleido-mastoideus. 

b.  Drawn  down  by :  subclavius,  pectoral,  major,  deltoideus. 

417.  B.  The  scapula  is  drawn  : 

a.  Upwards  by  :    lev.  anguli  scap.,  and  cucullaris. 

b.  Forwards,  inwards,  and  downwards  by :  pectoral,  minor, 
coraco-brachialis. 

c.  Forwards  and  outwards  by  :  serratus  ant.  major. 

d.  Backwards  by :  rhomboidei,  cucullaris. 
[The  shoulder  is  rotated  by :  cerratus  ant.  major. 

418.  C.  The  humerus  is: 

a.  Abducted  by ;  deltoideus,  coraco-brachial,  supra-spinalus. 

b.  Adducted  by  :  pectoral,  major.,  latissim.  dorsi,  teres  major. 

c.  Rotated   outwards  by :    infra-   and   supra-spinatus,   teres 
minor  ;  inwards  by  :  subscapularis  and  teres  major. 

419.  D.  The  fore-arm  is  : 

a.  Flexed  by :  biceps  and  brachialis  internus. 

b.  Extended  by  :  triceps  and  anconxus. 

c.  Proned  by :  pronator  teres  and  quadratus. 

d.  Supined  by  :  supinator  longus  and  brevis. 

420.  E.  The  hand  is  : 

a.  Flexed  by:  flexor  carpi  radial,  and  ulnaris,palmaris  longus. 


190  SPECIAL  ANATOMY. 

b.  Extended  by  ;  extensores  carpi  radiales  and  ulnaris. 

c.  Adducted,  that  is,  moved  towards  the  ulnar  border  of  the 
arm  by :  flex,  and  extern,  carpi  ulnaris  ;  abducted  (towards  the 
radial  border)  by :  extens.  and  flexor  radiales  carpi ;  Proned 
and  supined,  see  D. 

421.  F.  The  fingers  are : 

a.  Flexed  by :  flexor  digitor.  (sublimis  second  phalanx  of  the 
second,  third  fourth,  and  fifth  fingers) ;  by  flexor  digitor.  pro- 

fundus  (third  phalanx  of  the  same  fingers ;  by  lumbricales  (first 
phalanx  of  the  same  fingers) ;  first  phalanx  of  thumb,  by  flexor 
pollicis  brevis,  second  phalanx  by  fl.  poll,  longus  ;  of  little  finger, 
byfl.  digiti  minimi. 

b.  Extended  by :  extens.  comm.  (second,  third,  fourth,  and 
fifth  fingers);  the  thumb  by:  extens.  pollic.  long.,  brevis  and 
abductor  longus  ;  the  index  finger  by  :  extens.  indicis  ;  the  fifth 
finger  by  :  extens.  dig.  minimi  propr. 

c.  Adducted  (towards  the  middle  finger)  by:  interossei  and 
adduct.  pollicis. 

d.  Abducted  by  :  interossei,  abduct,  pollic.  and  digiti  minimi, 

e.  The   thumb   and  little  finger  approximated  by:  opponens 
pollic.  and  digit,  min.,  whereby  the  hand  is  made  hollow. 

422.  IV.  Inferior  Extremity. 
A.  The  thigh  is  : 

a.  Flexed  by :  psoas  and  iliacus  [and  pectineus']. 

b.  Extended  and  abducted  by  :  gluttei  (3). 

c.  Adducted  by  :  adductor es  (3)  and  pectinseus. 

d.  Rotated   outwards  by:  pyriformis,  gemelli,   obturatores, 
quadratus  femoris . 

e.  Rotated  inwards  by :  tensor,  fasciae  lat.,  and  the  anterior 
part  of  glutseus  med.  and  minimus. 

423.  B.  The  leg  is : 

a.  Flexed  by :  biceps,  semitendinosus,  semimembranosus,pop- 
litseus,  sartorius  gracilis. 

b.  Extended  by :  vastus  externus  and  internus,  cruralis  and 
rectus  femoris.     These  muscles  assist  at  the  same  time  to  flex 
the  pelvis  upon  the  thighs. 

c.  Rotated,  outwards,  by:    biceps;  inwards,  by:    sartorius, 
gracilis,  semitendinosus,  poplitxus. 

424.  C.  The  foot  is  : 

a.  Extended  by :  gastrocnemius,  solxus,  plantaris  longus ; 
tibialis  posticus  and  peronei  long,  and  brevis ;  assisted  by  the 
flexors  of  the  toes. 


THE  MUSCLES.  191 

b.  Flexed  by:  tibialis  anticus  andperonseus  tertius;  assisted 
by  the  extensors  of  the  toes. 

c.  Adducted  by :  tibialis  anticus  and  posticus. 

d.  Abducted  by :  peronsei  (3).     Neither pronators  nor  supina- 
tors  are  found  on  these  bones. 

425.     D.  The  toes  are : 

a.  Extended  by:    extens.  digitor.  comm.    long,  and  brevis 
(second,  third,  fourth,  and  fifth  toes),  extens.  halluc.  longus. 

b.  Flexed  by:  lumbricales  (first  phalanx)  -,flex.  comm.  brevis 
(second  phal.),  comm.  long,  (third  phal.)  and  caro  quadrata;  the 
great  toe  by  flex,  halluc.  prop.  long,  (second  phal.),  brevis  (first 
phal.). 

c.  Adducted  by :  interossei  interni,  adduct.  hallucis. 

d.  Abducted  by :  interossei  externi,  abduct,  hallucis  and  digiti 
minimi. 


SPLANCHNOLOGIA. 

OF  THE  VISCERA. 


"  The  best  means  of  avoiding  the  errors  which  have  now  been  referred  to, 
(viz.,  the  construction  of  hypothetical  theories,  or  the  assumption  of  principles 
which  are  altogether  gratuitous  and  imaginary,  and  the  deduction  of  general 
principles  or  conclusions  from  a  limited  number  of  facts,)  will  probably  be, 
to  keep  in  mind  the  important  principle,  that  the  object  of  physical  science  is, 
'to  ascertain  the  universality  of  a  fact.'  A  considerable  number  of  medical 
doctrines,  there  is  reason  to  apprehend,  will  come  out  of  the  examination  in 
rather  an  unsatisfactory  manner,  if  we  apply  to  them  the  tests  which  this  rule 
would  furnish,  namely — are  they  facts,  and  are  these  facts  universal1?" — ABEH- 
CROMBIE.  Path,  and  Pract.  Researches  on  the  Diseases  of  the  Stomach,  4r., 
Preface. 


13 


THE  VISCERA. 

LITERATURE : 

Organs  of  Digestion  : 

Todd,  R.  B.,  M.  D.     Croonian  Lectures.     Med.  Gaz.  1839,  1840. 

King,  T.  W.  Obs.  on  the  Stomach.  Guy's  Hosp.  Rep.,  vol.  vii.,  and  the  suc- 
ceeding. 

Goodsir,  J.  4-  H.  Anat.  and  Path.  Obs. :—"  The  Structure  and  Functions  of 
the  Intestinal  Villi,"  p.  4.  Also,  the  Serous  Membranes,  p.  41. 

Nasymth.  Researches  on  the  Devel.,  Struct.,  &c.  of  the  Teeth,  and  Med. 
Chir.  Trans.,  1839. 

Goodsir,  J.  Origin  and  Development  of  the  Teeth.  Edin.  Med.  and  Surg. 
Journal,  1839. 

Wharton.     "  Adenographia."     1656. 

Houston.     "  On  the  Muc.  Memb.  of  the  Rectum."     Dubl.  Hosp.  Rep.,  vol.  v. 

Bell,  Thomas,  F.  R.  S.     On  Anat.,  Phys.,  &c.  of  the  Teeth. 

Kiernan.     Philos.  Trans.,  1833. 

Sudd.     Anatomy  of  Liver.     Diseases  of.     1845. 

Leeuvenhoek.  Microscop.  Obs.  on  the  Blood-vessels  and  Memb.  of  the  Intes- 
tines. Phil.  Trans.,  1706. 

Lieberkuhn.  Diss.  Anat.-phys.  de  Fabrica  et  Actione  Villorum  Intestinorum 
tenium  Hominis.  1745. 

Peyer,  J.  Conrad.     De  Gland.  Intestinorum.     1677. 

Bnmner,  J.  Conrad.     Novarum  Glandul.  Intestinalium  Descriptio.  1686.     And 
Exercitatio  Anat.-med.  de  Gland,  in  Intestine  Duod.  Horn,  detectis.     1688. 
Organs  of  Respiration  :-— 

King,  T.  W.  Notes  by  Sir  A.  Cooper.  Obs.  on  the  Thyroid  Gland.  Guy's 
Hosp.  Rep.,  vol.  i.  p.  429. 

/.  Hilton.     On  the  Sacculus  Laryngis.     Guy's  Hosp.  Rep.,  vol.  ii. 

Jonas  King.  On  the  Forms  of  the  Cartilages  which  keep  open  the  principal 
Div.  of  the  Bronch.  Tubes.  Guy's  Hosp.  Rep.,  vol.  v. 

Cooper,  Sir  A.     Anatomy  of  the  Thy mus  Gland.     1832. 

Simon,  John.     Anat.  of  the  Thymus  Gland. 

Pearson,  G.  On  the  Coloring  Matter  of  the  Black  Bronchial  Glands.  Phil. 
Trans.,  1813. 

Organs  of  Generation: — 

Curling,  T.  B.  "Structure  of  the  Gubernaculum,  and  Descent  of  the  Tes- 
ticle." Lancet,  vol.  ii.  1840,  1841,  and  his  work  on  the  Diseases  of  the 
Testicle. 

Cooper,  Sir  A.     On  the  Testis.     4to.    1830. 

On  the  Anatomy  of  the  Breast.     4to.  1840. 

Hunter,  Dr.  W.     Anat.  Descrip.  of  the  Human  gravid  Uterus.     4to.  1794. 

Jones,  T.  Wharton.  Report  on  the  Ovum.  Brit,  and  For.  Med.  Rev.,  vol.  xvi. 
p.  513. 

Organs  of  Micturition: — 

Santorini.     "Obs.  Anatomicse,"  and  for  plates,  "Septemdecim  Tab."     1724. 

Colles.     Surgical  Anatomy,  1811,  for  Perinaeal  Fascia. 

Wilson.     Med.  Chir.  Trans.,  vol.  i.,  for  "Wilson's  Muscles." 

Guthrie.  Anat.  and  Descrip.  of  the  Neck  of  the  Bladder  and  Urethra,  1834, 
for  "Guthrie's  Muscles."  And  Anat.  and  Dis.  of  the  Urinary  and  Sexual 
Organs.  1843. 


195 


426.  THE   VISCERA, 

are  very  compound  organs,  consisting  of  various  tissues,  several 
of  which  together  form  a  system  destined  to  the  performance  of 
some  particular  function.  Belonging  to  this  division  we  have  the 
Organs  of  Digestion,  Respiration,  Generation,  Micturition,  and 
the  Senses. 

427.  A.  Organs  of  Digestion,  Organa  digestionis, 

consist  of  one  canal,  which  extends  from  the  opening  of  the 
mouth  to  that  of  the  anus,  and  several  appendages  (as :  oral  and 
salivary  glands,  liver,  ventral  salivary  glands,  spleen). 

a.  Parts  above  the  Diaphragm. 

428.  1.  Cavity  of  the  Mouth,  together  with  its  appendages. 

Cavum  oris,  mouth,  is  situated  at  the  inferior  part  of  the  face 
between  the  two  jaws  and  the  cheeks,  behind  the  lips  and  before 
the  pharynx.  Its  roof  forms  in  front  the  hard  palate,  behind  the 
soft;  its  floor  the  tongue  and  mm.  genio-,  hyo-glossi,  genio-  and 
mylo-hyodei.  Before,  it  opens  externally  between  the  lips ;  be- 
hind, through  the  fauces,  isthmus  faucium,  into  the  pharynx. 
The  anterior,  or  buccal  cavity,  is  the  space  between  the  cheeks 
and  the  dental  alveoli;  the  proper  mouth,  the  space  between  the 
dental  alveoli  and  the  fauces. 

The  Lips,  labia,  form  the  moveable  anterior  wall  of  the  cavity  of  the 
mouth,  separated  by  the  transverse  oral  fissure,  os,  into  the  upper  and  under 
lips,  placed  (in  man)  vertically  over  one  another,  before  the  alveoli  and  the 
teeth.  Their  thick,  everted,  red  edges,  prolabia,  are  bounded  laterally  by  the 
angle  of  the  mouth,  angulus  oris.  On  the  anterior  surface  covered  by  the  ex- 
ternal skin,  the  upper  lip  is  bounded  by  the  skin  of  the  cheek  at  the  projecting 
internal  border  of  m.  levator  labii  super,  alaque  nasi,  the  under  lip  at  the  inner 
border  of  m.  triangularis.  The  linea  naso-labialis  (s.  abdominalis)  thence  arising 
(the  strongly-marked  furrow  of  intestinal  disorder),  commences  at  the  ake  of 
the  nose,  and  terminates  at  the  sides  of  the  chin.  On  the  upper  lip  we  ob- 
serve:  the  mustachios,  mystax;  in  the  centre  a  longitudinal  furrow,  phitirum; 
on  the  under  lip :  the  beard,  pappus;  upon  the  transverse  groove  or  the  bound- 
ary between  the  under  lip  and  chin,  sulcus  mento-labialis. — The  posterior  (in- 
ternal) surface  of  the  lips  is  covered  with  mucous  membrane,  which  applied 
to  the  gums,  is  beset  with  glands,  glanduke  salivates  labiaks,  and  in  the  centre, 
particularly  of  the  upper  lip,  forms  a  fold,  frenulum.  Between  the  external 
skin  and  the  mucous  membrane  is  placed  the  proper  foundation  of  the  lips, 
namely,  m.  orbicularis  oris  (see  before),  together  with  fibres  from  the  muscles 
bordering  it. 

Vessels  of  the  lips. — Arteries:  1.  Artt.  coronaria  from  art.  fadalis.  2.  Jhrtt. 
buccales,  infraorbitales,  alveolares  for  the  upper  lip, — from  Art.  maxillar.  interna, 
— mentaks  for  the  under  lip  from  art.  fadalis.  Veins :  plexus  labialis,  opens 


196  SPECIAL  ANATOMY. 

into  Ven.  facialis  anterior. — Lymphatics :  open  into  the  glands  at  the  base  of 
the  chin. 

Nerves:  first  division  of  fifth  and  seventh  cerebral  nerves,  from  pkxw  in- 
fraorbitalis  and  mentalis. 

Uses  of  the  lips :  Sucking,  Speech,  &c.,  expression  of  the  affections.  The 
under  lip  more  especially  prevents  the  efflux  of  saliva. 

Cheeks,  bucca,  gence,  bounded  above,  by  the  Basis  orbitce,  below,  by  the  basis 
and  externally  by  the  posterior  border  of  the  lower  jaw,  consist  of  the  follow- 
ing parts : — 

Skin,  very  vascular,  delicate,  particularly  in  the  region  of  eminentia  malaris 
(malar  bone),  where  it  is  firmly  fixed;  beset  with  the  whiskers,  julus.  A  de- 
posit of  fat,  thick  irUhe  central  region,  between  m.  masseter  and  buccinator. 

Muscles:  1.  M.  masseter.  and  risorius  in  the  regio  masseterica.  2.  Muse,  or- 
bicularis  palpebr.  in  the  regio  malaris.  3.  M.  buccinator,  zygomat.  major  and 
minor  in  the  reg.  buccalis. 

Salivary  glands :  glandulce,  buccales,  between  the  muscles  and  the  mucous 
membrane  opening  upon  the  last;  two  larger,  gl.  molares,  lie  betweeen  m.  buc- 
cinator arid  masseter,  and  open  in  the  region  of  the  last  molar  teeth. 

The  mucous  membrane  is  perforated  in  the  region  of  the  first  and  second 
superior  molar  teeth  by  ductus  Stenonianus.  Ductus  Stenonianus,  accompanied 
by  nerv.  buccal.  med.,  below  art.  transv.  faciei,  curves  inwards  at  the  anterior 
border  of  m.  masseter,  perforates  the  fat  which  covers  the  m.  buccinat.  and  the 
muscle  itself  at  a  distance  of  five  lines  from  m.  masseter  and  four  from  the  in- 
ferior border  of  os.  zygomat. 

Vessels. — Arteries :  1.  Branches  of  art.  maxillar.  externa  and  transversa  faciei. 
2.  Branches  of  art.  maxillaris  interna,  as:  infraorbitalis,  dentalis  infer.,  buccalis, 
masseter.,  alveolaris.  Veins :  plexus  buccalis,  which  opens  into  the  v.  facialis  an- 
terior. Lymphatics :  they  pass  into  the  glands  in  the  parotis  and  of  the  neck. 

Nerves:  1.  Branches  Of  N.  facialis,  buccales,  and  malares.  2.  Branches  of 
N.  trigeminus,  rami  bucdnatorius,  massetericus,  infraorbitalis,  mentalis. 

Uses:  Chewing.  Sucking,  Speech,  &c. 

The  Palate,  palatum  durum,  is  formed  by  the  processus  palatini  of  the  upper 
ja'w  and  the  horizontal  of  the  palate  bones,  covered  by  a  spongy  thick  mem- 
brane, perforated  by  vessels,  nerves,  and  glands,  membrana  pulposa  palati, 
which,  especially  anteriorly,  in  the  rough  places,  is  firmly  connected  with  the 
periosteum.  It  is  vaulted,  presents  in  the  middle  line  a  suture,  and  at  the 
anterior  termination  of  this  the  opening  of  canalis  incisivus  (for  nerv.  naso- 
palatinus} . 

Salivary  glands :  glanduke  palatines  are  particularly  numerous  at  the  pos- 
terior extremity  of  the  raphe. 

Vessels.     Jlrt.  et  ven :  Branches  of  the  spheno-  and  pterygo-palatina. 

Nerves :  naso-palatinus  Scarpce.  and  palatinus  anterior. 

The  soft  palate,  palatum  molle  s.  mobile,  velum  palatinum,  velum  pendulum, 
palati,  is  the  membrano-muscular  valve  which  separates  the  oral  from  the 
nasal  cavities  and  pharynx.  It  hangs  downwards  in  a  curvilinear  form  from 
the  posterior  border  of  the  hard  palate,  in  swallowing  (during  the  passage  of 
food)  horizontal ;  it  presents  an  inferior  concave  and  a  superior  convex  sur- 
face which  elongates  the  floor  of  the  nasal  fossae.  From  the  centre  of  the  in- 
ferior border,  the  uvula  is  dependent,  the  apex  of  which  may  sometimes  rest 
upon  the  basis  of  the  tongue,  a  few  lines  before  the  opening  of  the  larynx, 
and  sometimes  it  is  fissured.  The  lateral  borders  of  the  velum,  between  the 


THE  VISCERA.  197 

posterior  extremity  of  the  superior  and  that  of  the  inferior  alveolus,  correspond 
to  the  anterior  border  of  the  m.  pterygoid.  interims,  consisting,  to  a  great  extent 
(especially  behind  the  last  inferior  molar  tooth),  of  a  series  of  glands.  From 
the  Uvula  two  folds  pass  downwards  on  either  side,  the  palatine  arches,  and 
form  the  Isthmus  faucium. 

1.  Jlrcus  palatinus   anterior  s.  glosso-palatinus,  the  anterior   palatine  arch, 
arises  from  the  base  of  the  uvula,  is  connected  at  the  borders  of  the  tongue, 
in  the  region  of  the  anterior  extremities  of  the  papilla  calcince,  which  are 
arranged  in  the  figure  of  the  letter  V  with  these,  and  contains  the  mm.  glosso- 
palatini, 

2.  Jlrcus  palatinus  posterior  s.  pharyngo-palatinus  arises  from  the  apex  of  the 
uvula,  passes  obliquely  downwards,  backwards  and  outwards  to  the  sides  of 
the  pharynx,  is  smaller,  but  reaches  farther  inwards  ;  it  contains  the  mm.  pha- 
ryngo-palatini,  and  is  uneven  in  consequence  of  a  circle  of  glands.     Between 
the  two  arches  are  situated  on  either  side  in  a  depression,  one  of  the 

3.  Tonsils,  tonsilla,  amygdalae,  that  is,  a  group  of  mucous  follicles,  com- 
pound glands,  which,  directed  obliquely  downwards  and  forwards,  is  turned 
towards  the  internal  (free)  surface  of  the  perforated  mucous  membrane,  co- 
vered externally  by  the  fascia  pharyngea  and  the  angle  of  the  lower  jaw. 
The  tonsils  consist  chiefly  of  uniting  tissue  disposed  in  channels  in  which 
the  numerous  vessels  pass,  and  between  which  the  granular  glandular  mass 
is  placed  with  many  excretory  ducts.     Arteries  come  from  art.  labialis,  pha- 
ryng.  inferior,  lingual.,  palatina  infer,  and  superior.     Veins:  plexus  tonsiUaris 
from  plexus  pharyngeits.      Nerves  :  are  branches  of  N.  lingual,  and  glosso-pha- 
ryngeus,  on  the  outer  border.     Function  :  to  secrete  mucus  which  lubricates 
the  fauces. 

4.  Isthmus  faucium.  the  fauces,  that  is,  the  opening  between  the  palatine 
arches,  which  may  be  contracted  by  the  tonsils  and  by  the  play  of  the 
muscles. 

The  mucous  membrane  of  the  soft  palate  is  covered  with  little  glands  (g/. 
salivares),  at  the  free  extremity  more  delicate.  The  numerous  arteries  come 
from  Art.  palatina,  ascendens  and  descendcus.  Veins  :  of  the  same  name. 
Nerves  :  branches  of  rami  palatini  from  Ganglion  'Meckelii  and  n.  glosso-pharyn- 
geus.  (The  uvula  contains  much  loose  uniting  tissue,  which  is  easily  infil- 
trated with  blood  or  serurn).  Muscles  (see  before). 

Uses  of  the  soft  palate  :  in  deglutition,  speech  and  singing. 


429.  1.  The  Tongue,  Lingua,  yXw 

the  muscular  organ  for  taste,  is  situated  above,  before  and  at  the 
sides,  free  and  moveable,  in  the  cavity  of  the  mouth,  attached  by 
ligaments  to  the  hyoid,  bone  and  by  muscles  to  this,  to  the  Proc. 
styloidei  and  lower  jaw  ;  before  horizontal,  then  curved  and  to- 
wards the  hyoid  bone  almost  perpendicular.  Here  at  the  root, 
radix  s.  basis  linguse,  it  is  also  connected  with  the  epiglottis. 
Its  point,  apex,  is  placed  close  behind  the  incisor  teeth.  The 
superior  free  surface,  dor  sum  linguae,  divided  by  a  groove  into 
two  lateral  halves,  is  rough,  covered  with  numerous  mucous 
glands  and  lingual  papilla?  ;  the  inferior  surface  is  free  in  the  an- 
terior third  only  ;  it  presents  in  the  centre  a  groove,  at  the  sides 
of  which  the  Fv.  raninse  and  Mm.  linguales,  and  ihefrenulum, 


198  SPECIAL  ANATOMY. 

that  is,  a  fold  of  the  oral  mucous  membrane,  which,  abstractedly 
of  the  muscles,  attaches  the  tongue  to  the  floor  of  the  mouth.  On 
either  side  of  the  frenulum  behind  the  excretory  ducts  of  the 
salivary  glands  bursae  mucosx  are  placed  (according  to  Fleisch- 
mann  the  seat  of  ranula). 

a.  The  substance  of  the  tongue,  caro  lingua,  consists  for  the  most  part  of 
m.  lingualis,  which  forms,  on  the  superior  and  inferior  surfaces,  a  longitudinal 
layer  extending  from  the  hyoid  bone  to  the  apex  of  the  m.  stylo-glossi,  the 
internal  fibres  of  which  are  transverse,  and  mm.  genio-glossi,  the  fibres  of 
which,  curved  above,  pass  vertically,  and  mm.  hyo-glossi,  which  likewise  enter 
the  tongue  vertically  between  m.  lingualis  and  stylo-glossi.     In  the  centre  of 
the  root,  attached  to  the  anterior  surface  of  the  Basis  oss.  hyoidei,  a  thin 
lamina  of  cartilage  is  found,  the  inferior  border  of  which  lies  between  mm. 
genio-glossi. 

b.  The  lingual  membrane,  involucrum  s.  cutis  lingua,  thicker  than  the  mu- 
cous membrane  of  the  mouth,  and  firmly  attached  to  the  places  where  it  is 
beset  with  papillae,  is  covered  with  Epithelium  (periglottis}.     It  forms  besides 
the  frenulum  lingua,  3  ligg.  glosso-epiglottica,  from  the  root  of  the  tongue  to  the 
Epiglottis,  and  several  triangular  folds,  fimbria  lingua,  under  the  borders  of 
the  tongue. 

c.  Lingual,  or  gustatory  papillae,  papilla  lingua,  are  small  elevations  upon 
the  back  and  edges  of  the  tongue,  composed  of  condensed  uniting  tissue,  and 
provided  with  capillary  vessels  and  delicate  nerve  filaments. 

1.  Papillae,   vallatce,  s.  truncate  s.   calirince,  7 — 16 — 20,  in  the  form  of  a 
capital  V  (the  apex  behind — the  last  called  foramen  ccecum  s.  Meibomii)  at  the 
root  of  the  tongue,  like  an  inverted  cone,  surrounded  all  round  with  a  fossa 
and  a  wall. 

2.  Pap.  conicte,  filiformes,  the  smallest  and  most  numerous,  lying  on  the 
apex  and  the  anterior  part  of  the  back  of  the  tongue,  in  an  oblique  direction 
from  before,  backwards. 

3.  Pap.  knticulares  s.  fungiformes,  which,  shaped  like  a  club,  are  found  dis- 
persed between  the  Pap.  conicee.     At  the  edges  obliquely  inwards  towards 
the  root  of  the  tongue,  we  find  four  or  five  parallel  fissures  beset  with  nervous 
papillae;  these  are  ruga  transverse  jUrnoldi  (s.  pap.  lingualis  foliata,  Mayer). 

Uniting  and  adipose  tissue  is  dispersed  particularly  at  the  posterior  part  of 
the  tongue. 

Vessels :  Jirtt.  and  Ven.  linguales,  palatinte  and  pharyngea  inferiores. 
Nerves:  1.  Hypoglossus.     2.  Ram.  lingualis  N.  quinti.     3.  Glosso^pharyngea. 
Movements :  (see  Muscles,  before.) 

430.  2.  Salivary  glands  of  the  mouth,  glandulx  salivales  oris. 

a.  The  parotid,  gl.  parotis,  is  larger  than  the  other  salivary  glands,  irregular 
in  shape,  and  placed  before  and  below  the  auricle  of  the  ear. 

Basis,  or  external  surface :  broad,  oblong,  covered  by  fascia  parotidea,  m. 
risorius,  and  skin. 

Anterior  surface :  concave,  surrounds  the  posterior  border  of  ramus  maxillar. 
infer.,  separated  from  it  by  uniting  tissue ;  behind  m.  pterygoideus  intern.,  lig. 
stylo-maxillare,  m.  masseter,  from  the  external  surface  of  which  it  is  separated 
by  rami  n.farialis,  loose  uniting  tissue,  and  art.  transversa  faciei. 

Posterior  surface,  likewise  concave,  lies  against  the  cartilage  of  the  external 


- 
THE  VISCERA.  199 

auditory  meatus,  firmly  united  to  it,  before  Proc.  mastoideus,  Mm.  Stemo-cleido- 
mast.  and  digastric,  (post,  belly.) 

The  internal  edge  is  bounded  by  Proc.  Styloideus  and  the  muscles  arising 
from  it.  Between  mis  and  m.  pterygoideus  internus  we  find  a  prolongation, 
with  a  groove  for  Art.  carotis  externa.  The  superior  border  lies  under  Arcus 
zygomat.  and  Artie.  temporo-maxiUar.  The  inferior  extremity  fills  the  space 
between  angulus  maxittar.  inf.  and  m.  sterno-cleido-mast.  separated  from  the  gl. 
submaxiUaris  by  a  fibrous  septum. 

Withinside  the  gland  are  situated,  Artt.  temporalis,  transv.  faciei,  auriculares 
anterr.;  V.  facial,  posterior  ;  N.  facialis  and  its  plexus  anserinus  •  N.  auricular. 
from  plexus  cervicalis,  but  superficial ;  (red)  lymphatic  glands. 

Structure.  Single  acini  are  united  into  lobuli,  which  are  held  together  by 
the  dense  general  envelope  of  the  gl.  parotis. 

The  Excretory  duct,  ductus  Stenonianus,  arising  from  the  associated  ducts  of 
all  the  acini,  passes  out  from  the  centre  of  the  anterior  border  of  the  gland, 
crosses  horizontally  forwards  (below  art.  transv.  faciei)  five  or  six  lines  under 
the  zygoma,  over  the  external  surface,  to  the  anterior  border  of  the  m.  mas- 
seter,  curves  at  this  point  around  a  mass  of  fat,  perforates  it  and  m.  buccinator 
vertically,  and  passes  for  some  lines  between  it  and  the  mucous  membrane, 
until  it  opens  in  the  region  of  the  first  and  second  molar  teeth.  It  is  thicker 
at  the  anterior  than  at  the  posterior  extremity;  it  consists  of  an  internal  (mu- 
cous) and  an  external  coat,  and  is  rather  extensible.  At  the  posterior  ex- 
tremity a  small  lobule  is  sometimes  attached,  parotis  accessoria. 

The  vessels  of  the  Parotis  are  numerous :  Artt.  are  branches  of  the  temporal., 
transvers.  and  auricularis.  Vv.,  like  the  nerves,  form  a  plexus  parotideus,  and 
fall  into  V.  facial,  posterior.  Vas.  lymph,  enter  the  lymphatic  glands  at  the 
angul.  maxitt.  and  those  before  the  external  auditory  meatus. 

Nerves:  they  are  branches  ofplex.  anserinus  and  N.  auricular,  anter. 

b.  The  submaxillary  gland,  glandula  submaxillaris,  oblong,  flat,  bipartite, 
placed,  partly,  on  the  internal  surface  of  the  basis  max.  inf.,  covered  externally 
and  below  by  fasc.  cervical.,  v.  facial,  ant.,  m.  platysma  myoides,  and  skin ;  in- 
ternally, by  nerv.  lingualis  and  hypoglossus  and  m.  hyo-glassus,  with  a  groove 
(behind)  for  Art.  maxiUar.  externa ;  meets  behind  with  the  post,  belly  of  m. 
digastricus ;  surrounds  in  front  the  posterior  border  of  m.  mylo-hyoideus ;  and 
connected,  above  the  last,  with  gl.  subling.,  it  gives  off  at  this  point  its  excre- 
tory duct,  the 

Ductus  Whartonianus,  shorter,  more  delicately  membranous,  but  wider  than 
the  d.  Stenon.,  passes  obliquely  from  below  upwards,  and  from  without  in- 
wards, parallel  with  n.  hypogloss.  and  lingualis,  at  the  commencement  be- 
tween m.  mylo-hyoideus  (above  this)  and  hyo-glossus,  then  between  m.  genio- 
glossus  and  gl.  sublingualis,  on  its  internal  surface,  always  close  beneath  the 
mucous  membrane,  and  opens  at  the  sides  of  frenulum  lingua  in  the  papilla 
caruncula  sublingualis,  behind  the  inferior  incisor  teeth. 

Vessels :  Artt.  are  branches  of  maxillar.  externa.,  Vv.  pass  into  the  ven.  facia- 
lis anter. 

Nerves:  they  come  from  the  gangl.  maxillare  nerv.  lingualis. 

c.  The  sublingual  glands,  glandula  sublingualis,  small,  oblong,  flat,  in  a  fossa 
of  the  lower  jaw  close  to  Spina  internamenti,  projects  inwards  into  the  cavity 
of  the  mouth,  covered  at  this  spot  with  mucous  membrane  only,  close  to  the 
frenulum  •  they  rest  upon  m.  mylo-hyoideus  (between  the  two  gangl.  sublinguale) ; 
the  internal  surface  is  directed  towards  m.  genio-glossus  and  separated  from 
the  last  by  N.  lingualis,  ductus  Wharton.,  V.  ranina.     The  anterior  extremity  of 


200  SPECIAL  ANATOMY. 

one  sublingual  gland  meets  that  of  the  other ;  the  posterior  extremity  and  the 
inferior  border  surround  the  nerv.  lingualis. 

The  excretory  ducts :  1,  d.  Bartholinianus  opens  upon  the  caruncula  sub- 
lingualis,  or  unites  with  the  duct.  Whartonianus.  2.  d.  Riviani;  from  seven 
to  twelve  small  ducts  open  along  the  frenulum  upon  the  mucous  membrane  of 
the  mouth,  or  are  associated  with  the  ductus  Bartholin. 

Vessels:  Artt.  and  Vv.  are  branches  of  sublingualis. 

Nerves :  branches  of  ram.  lingualis  trigemini  with  gang,  sublinguak. 

431.  3.  The  teeth,  denies,  mordices,  are  bone-like  bodies, 
fixed  (per  gomphosiri)  into  the  alveoli  of  the  jaws,  thirty-two  in 
number  (in  the  full-grown  adult),  consisting  of  a  soft  nucleus  sur- 
rounded by  a  hard,  brittle,  osseous  substance  (dentine)  and  the 
enamel.  The  crown,  corona  dentis,  projects  freely  into  the  mouth, 
covered  with  enamel;  the  neck,  collum,is  a  smaller  portion  sur- 
rounded by  the  gums ;  the  root,  radix,  is  fixed  into  the  alveolus 
(socket).  Both  the  alveoli  and  the  roots  of  the  teeth  are  covered 
with  a  delicate,  highly  vascular  periosteum,  which  enters  the 
cavity  in  the  interior  of  the  tooth  through  a  fine  foramen  at  the 
extremity  of  the  root,  and  surrounds  the  nucleus. 

a.  Incisor  teeth,  d.  indsivi  s.  primores, 

4  superior, 

4  inferior, 

in  the  centre,  at  the  anterior  part  of  the  arcus  alveolar es.  The  crown  is  chisel- 
shaped,  convex  in  front,  concave  behind,  the  free  edge  sharp  and  broader 
than  the  basis,  which  is  thicker;  the  root  is  single  (rarely  double),  conical,  flat 
at  the  sides,  obtuse  at  the  point.  The  superior  incisors  are  stronger  than  the 
inferior,  the  central  (superior)  stronger  than  the  external.  The  superior 
converge  downwards ;  the  external  inferior  diverge  upwards. 

b.  Corner,  canine  teeth,  d.  canini  s.  cuspidati, 

2  superior  (eye  teeth), 

2  inferior, 

the  one  by  the  side  of  the  external  incisors,  are  the  longest,  especially  the 
superior.  The  crown  thick,  irregular,  conical,  triangular,  pointed;  the  root 
longer  (especially  the  superior)  and  thicker  than  the  rest  of  the  teeth,  single. 
The  inferior  canine  teeth  are  received  (when  the  teeth  are  closed)  between 
the  superior  canine  and  external  incisors. 

c.  Back,  masticating  teeth,  d.  molares. 

10  superior, 
10  inferior, 

five  upon  each  side,  next  to  the  canine  tooth.  The  crown  is  short,  almost 
cubical,  the  free  extremity  quadrangular  and  uneven;  root  compound. 

We  distinguish:  1.  dent,  molares  minores ;  these  are  the  two  anterior  next 
the  corner  teeth.  Their  crown  is  small,  with  two  tubercles  (bicuspidati') ; 

4  superior, 
4  inferior; 


THE  VISCERA.  201 

their   root   single,   flat,   or    (rarely)    slightly   bifurcated.     The   superior  are 
stronger;  the  root  of  the  second  superior  bicuspis  is  usually  bifurcated. 

2.  D.  molares  majores,  the  three  posterior  back  teeth  (the  last  called  dens 
sapientice).  have  a  low  broad  crown  with  three  or  four  tubercles  (<ri,  quadri- 
cuspidati.)  and  two,  three,  or  four  at  one  time  parallel,  at  another  diverging, 
or  hooked,  curved  roots ;  those  of  the  wisdom  teeth  are  united  into  a  single 
root.  Lent,  molar,  major. 

6  superior, 
6  inferior, 

[Dental  formula: 

I 

'ft 
I 


"Z         ° 
3  2 


1 1 


I 

jj 

3 

0                 0 

•  ~        i' 

r' 

i 

1 

1 

I      I 

J       1 

| 

3 

2 

1 

2 

2 

1       2 

3 

S 

2 

1 

2 

2 

1       2 

9 

4  i__i  5—5 

Incisors  —  Canines Molars =32.     TRAXS.] 

4  i_i  5—5 

Elements  of  the  teeth. 

1.  Dentine,  substantia  ossea  s.  ebur,  forms  the  principal  mass  and  the  founda- 
tion of  the  teeth,  is  marrowless  and  non-vascular,  formed  of  layers  not  of 
canals,  harder  and  more  transparent  than  the  (common)  substance  of  the 
bones,  of  which  a  thin  layer  covers  the  external  and  internal  surfaces  of  the 
root  of  the  tooth.     It  is  yellowish  white,  iridescent,  consisting  of  concentric 
layers  and  parallel  longitudinal  fibres  and  especially  rich  in  Chondrin.     This 
last  is  wanting  in 

2.  The  Enamel,  subst.  vitrea  s.  corticalis,  which  covers  the  crown,  is  bluish 
white,  very  hard  (resisting  the  file)  and  heavy,  presents  horizontal   fibres, 
and  is  said  to  be  deposited  from  a  peculiar  organ,  membrana  adamantina 
(Purkinje). 

1.  Subst.  ossea.  2.  Subst.  vitrea. 


Phosphate  of  lime           -  -  61 '95 

magnesia  -  -  ]-05 

Carbonate  of  lime           -  -  5-30 

Fluoride  of  calcium         -  -  2*10 

Soda  and  common  salt   -  -  1*40 

Cartilage  and  water        -  -  28-00 


Phosphate  of  lime           -         -  85-3 

Carbonate  of  lime            -         -  8'0 

Phosphate  of  magnesia  -         -  1'5 

Membranes,  soda  and  water  -  02 


202  SPECIAL  ANATOMY. 

3.  The  nucleus,  germ  of  the  tooth,  nucleus  s.  pulpa  dentis,  lies  in  the  cavity 
of  the  tooth,  cavum  dentis,  the  shape  of  it  being  determined  by  that  of  the 
cavity;  it  is  a  reddish  body,  consisting  of  uniting  tissue,  capillary  vessels  and 
nerves,  surromuled  by  a  thin  and  very  sensitive  membrane.  The  arteries 
come  from  Art.  maxillar.  internet.  (Artt.  alveolar,  anter.,  poster.,  and  infer.') ;  the 
veins  open  into  Ven.  fadalis  ant.  and  post. ;  the  nerves  are  branches  of  ram. 
maxillar.  super,  and  inferior  (N.  alveolar,  ant.,  poster,  and  inferior}. 

432.  The  tissue  of  the  gums,  gingiva  (oi&ov),  thicker  and 
more  firm  than  the  mucous  membrane  of  the  mouth,  the  continu- 
ation of  which  it  is,  covers  the  alveolar  processes  of  the  jaws, 
and  is  connected  with  the  periosteum  by  a  very  vascular,  loose 
uniting  tissue.     It  turns  over  the  free  edge  of  the  alveolus  for 
about  a  line  broad,  and  then  passes  into  the  periosteum  of  the 
alveoli.     It  is  provided  with    the  glandul.   tartaricdK,   mucous 
glands,  which  deposit  the  so-called  tartar;  little  sensitive  when 
cut,  more  when  pressed;  becomes  hard  like  cartilage  after  the 
teeth  have  fallen  out,  when  it  covers  over  the  alveoli.     Arteries : 
coronar.    super.,   submental.,   sublingual.      Nerves:    from   n. 
quintus. 

433.  Development  of  the  Teeth. 

a.  Before  their  eruption.     The  jaws  of  a  two  to  three  months'  fetus  pre 
sent  a  broad  and  deep  fossa,  which  is  divided  by  thin  septa  into  cells,  and 
closed  upon  the  free  border  by  a  whitish  and  firm  fibrous  tissue  (dental  car- 
tilage). 

At  the  time  when  the  dental  sacculi  form,  prolongations  of  the  dental  car- 
tilage go  to  the  floor  of  each  cell,  line  it  from  without,  and  leave  a  small 
opening,  only,  for  the  entrance  of  the  vessels  and  nerves. 

The  dental  sacculi,  folliculi  dentium,  are  closed  membranes,  filled  with  a 
reddish,  viscous  fluid,  four  of  which  appear  in  the  middle  of  the  third  month, 
and  six  in  the  fourth  month,  in  each  jaw. 

The  tooth  germ,  pulpa  dentis,  elevates  itself  at  first  in  the  fourth  month, 
from  the  flood  of  the  sacculus,  as  a  papilla-shaped  body,  the  thin  pedicle  of 
which  forms  the  dental  vessels  and  nerves,  increases  by  degrees  into  the  sac- 
culus, it  becomes  the  nucleus  about  which  the  tooth  (the  crown  first)  forms. 
In  the  fifth  month  ossification  commences,  that  is  to  say,  thin  elastic  discs  of 
dentine  are  deposited  upon  the  surface  of  the  pulpa,  and  indeed,  so  many  as 
the  tooth  at  a  later  period  is  said  to  have  tubercles.  At  a  later  period  they 
coalesce  and  become  strengthened  by  new  discs  annexed  to  them  from  within. 
But  the  enamel  is  not  deposited  from  the  pulpa,  nor  even  from  the  reddish 
fluid  which  washes  round  it,  but  from  the  lamina  of  the  dental  sacculus  turned 
towards  the  cell,  and,  indeed,  from  an  enlargement  at  the  top  of  the  crown 
to  which  last  it  is  applied,  at  first  (even  in  the  mature  foetus)  as  a  soft  and 
moist  mass. 

In  the  fifth  month  the  central,  then  the  external,  incisor  teeth  form  and 
become  ossified;  in  the  sixth  month,  the  first  molar,  the  canine,  the  second 
molar  teeth. 

b.  Eruption  of  the  (milk)  teeth,  dentition,    eruptio  dentium,  dentitio  prima> 
When  after  the  birth  of  the   child  the  roots  of  the  teeth  have  reached  the 
floor  of  the  dental  cells,  the  gum,  in  consequence  of  their  farther  growth,  is 
pressed  upon,  inflames,  and  thence  becomes  perforated. 


THE  VISCERA.  203 

It  happens  in  the  following  order.  At  the  seventh  month  the  central  in- 
ferior, after  them  the  remaining  (generally,  the  central  superior,  first)  incisor 
teeth  ;  at  the  end  of  the  first  year  the  first  molars  ;  in  the  middle  of  the  second 
year  the  inferior  canine,  later  the  superior,  and,  at  the  end  of  the  second  year, 
the  second  molars  ;  in  the  whole  twenty  teeth. 

[Formula:  incisors  -;  canine  -  —  -;  molars  -  -  =  20.    TRANS.] 
4  1  —  I  &  —  <s> 

These  milk  temporary  teeth,  d.  lactanies  s.  temporarily  remain  until  the  or 
seventh  year,  when  they  make  room  for  the  permanent,  d.  permanentes.  The 
milk  teeth  are  smaller  and  narrower,  the  crown  and  root  do  not  pass  gradually 
into  one  another,  but  are  separated  by  a  kind  of  circle  ;  the  (superior)  first 
temporary  molar  has  three  roots  (the  permanent  only  one)  ;  the  (inferior) 
first  temporary  molar,  a  crown  with  several  and  sharp  points,  and  a  double 
root;  the  second  temporary  molar  a  broad  crown  and  five  points,  with  a 
double  or  three-fold  root. 

c.  The  change  of  teeth,  mutatio  dentium,  dentitio  secunda.  The  (thirty-two) 
permanent  teeth  are  also  developed  from  dental  sacculi,  of  which  those  which 
ought  to  occupy  the  places  of  the  twenty  temporary  teeth  are  situated  in  the 
same  cell  with  them,  the  twelve  to  be  newly  added  in  their  own  proper  cells. 
The  germs  form  in  the  following  order:  in  the  fifth  month  of  embryonic 
life  the  germ  of  the  third  molar  tooth  arises,  in  the  eighth  month  that  for  the 
remaining  incisor  teeth,  at  the  end  of  the  first  year  that  for  the  canine,  and 
rather  later  that  for  the  fourth  molar;  in  the  eighth  month  after  birth  the 
germ  for  the  first  and  second  ;  in  the  fourth  year  that  for  the  last  molar. 

The  decadence  of  the  temporary  teeth  is  preceded  by  a  diminution  of  the 
artery  which  passes  to  each,  whereby  the  root  of  the  tooth  is  first  absorbed, 
and  the  bony  canal  of  the  artery  contracted  ;  then,  in  the  ninth  year,  quite 
closed. 

The  eruption  of  the  permanent  teeth  takes  place  in  the  following  order  : 

C  The  middle  pair  of  the  superior,  later,  that  of 
In  the  seventh  year  appear  <      the  inferior  Incisors. 
The  three  Molar  teeth. 


In  the  eighth  year  -  T  te  SUpe°r 


£  The  Canine. 


In  the  ninth  year  The  first  and  second  Molars  (below  and  above). 

In  the  twelfth  to  the  thir- 

teenth year 

In  the  fourteenth  or  later          The  fourth  Molar,  and 
Between  the  twentieth  and  >  ,™  .   , 

thirtieth  5  The  last  °f  Wlsd°m  teeth' 

d.  The  decadence  of  the  teeth  in  old  age  is  normal,  and  appears  to  be 
effected  by  the  pulp  of  the  tooth,  by  degrees,  ossifying,  and  the  nourishing 
vessels  becoming  obstructed.  The  cells  also  in  which  the  teeth  are  seated 
fill  with  bone  earth  (the  teeth  become  apparently  longer),  their  edges  become 
absorbed,  and,  in  consequence,  the  jaws  lower,  the  gum,  after  the  decadence 
of  the  teeth,  draws  over  the  free  surface,  and  becomes  cartilaginous  (as  it  was 
before  in  the  suckling).  The  decay  of  the  teeth  appears  also  to  be  in  con- 
nection with  the  grinding  away  and  loosening  of  the  enamel  ;  the  crown  is 
already  worn  even  before  the  teeth  are  completely  perfect 

Anomalies  in  the  number  of  the  teeth.     Most  frequently  the  wisdom, 


204  SPECIAL  ANATOMY. 

sometimes  the  first  molar,  rarely  the  external  incisor  teeth,  remain  unde- 
veloped. Occasionally  some  molar  teeth  exceed  the  number  (more  frequently 
in  Negroes).  With  many  children  the  eruption  of  the  milk  teeth  takes  place 
before  birth.  A  third  mutation  sometimes  occurs  with  the  posterior  molar 
and  the  incisor  teeth. 

434.  5.  The  Pharynx, 

a  funnel-shaped  muscular  semi-canal  behind  the  nasal  and  oral 
cavities  and  the  larynx,  in  the  central  line  before  the  five  superior 
cervical  vertebrae,  at  the  superior  part  called  the  fauces,  is  closed 
above,  behind  and  at  the  sides,  but  before  and  below  (where  it 
passes  into  the  oesophagus)  open.  Narrower  than  the  mouth,  but 
wider  than  the  (Esophagus,  its  breadth  measures  above  (between 
the  posterior  borders  of  the  internal  wings  of  the  P.  pterygoidei) 
about  one  inch,  farther  down  (between  the  posterior  extremities 
of  the  alveoli)  two  inches  [during  contraction  of  the  muscles  only 
one  inch],  still  deeper  (between  the  inferior  cornua  of  the  thyroid 
cartilage)  rather  above  one  inch  [to  almost  complete  closure 
during  contraction  of  the  muscles].  Length  :  four  to  four  and  a 
half  inches  [may  be  elongated  to  about  five  and  a  half,  shortened 
to  two  and  a  half  inches]. 

The  external  surface  is  formed  of  a  muscular  coat,  behind, 
united  with  the  fascia  cervicalis  (profunda)  by  loose  uniting  tis- 
sue, and  is  situated  before  mm.  recti  capit.  antic.,  and  longus 
colli;  is  at  the  sides  separated  from  m.  pterygoideus  intern,  by 
a  triangular  (below  broad)  space,  in  which  are  found:  Carotis 
interna,  V.  jugular,  intern.,  Nn.  vagus,  glosso-pharyng.,  hypo- 
glossus,  accessor.  Willis.,  farther  down  many  lymphatic  glands 
and  Carotis  externa.  Above  (the  roof)  it  is  attached  to  the  pars 
basilar.  ossis  occipitis. 

The  internal  surface  is  covered  with  mucous  membrane.  The 
anterior  wall  is  wanting;  instead,  we  see:  1.  The  two  posterior 
nasal  openings.  2.  The  superior  surface  of  velum  palatinum, 
above  which  the  fluid  from  the  nose  flows  into  the  posterior  part 
of  the  mouth.  3.  The  semicircular  isthmus  faucium.  4.  The 
superior  opening  of  the  larynx  closed  by  the  epiglottis.  5.  The 
posterior  surface  of  the  larynx.  The  posterior  wall  is  even 
broader  above  than  below.  The  lateral  parietes  with  the  open- 
ing for  the  tuba  Eustachii  (at  the  same  elevation  as  the  posterior 
extremities  of  the  inferior  turbinate  bones). 

The  limit  between  the  pharynx  and  oesophagus  is  indicated 
by:  the  narrowness  of  the  tube,  the  paleness  and  the  altered 
direction  of  the  muscular  fibres  of  the  latter. 

Muscles  (see  Myology).  Fasciae:  1.  F. pharyngea  posterior  arises  from  the 
inferior  surface  of  pars  basilaris,  tuba  Eustachii,  and  serves  for  the  attachment 


THE  VISCERA.  205 

of  the  mm.  constrictor  pharyng.  2.  F.  pkaryngea  lateralis  arises  from  os 
pctrosum  (at  the  internal  border  of  the  inferior  opening  of  canal.  caroticusY 
passes  to  the  lateral  wall  of  the  Pharynx,  attaches  itself  in  the  fossa  pterygoid. 
between  m.  pterygoid.  intern,  and  circumflex,  palati,  with  a  process  to  the  m. 
buccinatorius,  covers  the  tonsils,  and  attaches  itself  to  the  superior  border  of  os 
hyoideum. 

Vessels :  Branches  of  Art.  pharyngea  ascendens,  thyreoidea  super,  and  infer., 
palatina  ascend,  and  pterygo-palatina. 

Veins  :  they  form  plex.  pharyngeus. 

Nerves:  plex.  pharyngeus  superior  and  inferior  (from  N.  vagus,  glosso-pha- 
ryngeus,  accessor.  Willis,  and  sympathicits^  and  ganglion  spheno-palatinum. 

435.  6.  The  (Esophagus, 

a  flat,  extensible,  muscular  canal,  from  eight  to  nine  inches  long, 
reaches  from  the  fifth  cervical  vertebra  as  far  as  the  tenth  dorsal, 
that  is,  from  the  inferior  opening  of  the  pharynx  to  the  superior 
of  the  stomach ;  narrowest  in  the  cervical  region,  widest  at  the 
inferior  extremity ;  and  closed  in  the  remaining  portion,  since  the 
anterior  comes  in  contact  with  the  posterior  wall. 

a.  Cervical  portion  :  1.  covered  in  front  by  the  trachaea,  to  the 
left  (as  the  oesophagus  deviates  to  the  left)  by  m.  sterno-thyreoid- 
eus  (sinister),  the  thyroid  gland,  N.  recurrens  (sinist.),  Art.  and 
Ven.  thyreoidea  infer. ^  connected  above  by  condensed  uniting 
tissue  with  the  trach&a;  2.  behind,  attached  by  loose  uniting 
tissue  to  the  vertebral  column;  N.  recurrens  dexter;  3.  at  the 
sides:  the  thyroid  gland,  Carotis  communis,  Ven.  jitgularis  in- 
terna. 

b.  The  thoracic  portion  passes  along  the  posterior  mediastinum. 
1.   Before  it  are  placed:    the    trachaea,  and  farther   down   the 
bronchus  sinister,  arcus  aortas,  and  lastly  the  pericardium  (with 
the  basis  and  posterior  surface   of  the   heart) ;  below  n.  vagus 
sinister.     2.  Behind  it:  the  vertebral  column  ;  separated  from  it 
by  uniting  tissue,  lymphatic  glands,    Ven.  azygos  and  ductus 
thoracicus  (above) ;  quite  below:   Aorta  thoracica  and  N.  vagus 
dexter.     3.  At  the  sides:    the  lungs,  separated  from  it  by  the 
middle  mediastinum  ;    the  whole  length  of  N.  vagus;    to  the 
right  (from   the   fourth   dorsal  vertebra)   on  ven.  azygos,  duct, 
thorac.;  to  the  left:  Jlorta  thoracica.     In  the  thoracic  portion 
the  (esophagus  projects  in  a  more  marked  manner  to  the  right. 

c.  The  abdominal  portion,  very  short  (rarely  an  inch),  passes 
through  foram.  cesophageum  of  the  diaphragm,  and  is  immedi- 
ately enveloped  by  peritonaeum  before  and  to  the  right  of  the  left 
lobe  of  the  liver,  behind  embraced  by  lobulus  Spigelii. 

Structure.  1.  Muscular  coat,  tunica  externa,  thick,  above  red,  below  paler: 
consists  of  an  external  layer  of  longitudinal  fibres,  which  descend  from  the 
posterior  surface  of  Cartilago  cricoidea,  and  are  lost  in  the  first  layer  of  the 


206  SPECIAL  ANATOMY. 

muscular  coat  of  the  stomach ;  and  of  an  internal  layer  of  circular  fibres, 
which  are  lost  in  the  third  layer  of  the  muscular  coat  of  the  same  organ. 

2.  Mucous  membrane,  tunica  internet,  is  connected  with  the  last  by  a  thin 
layer  of  uniting  tissue  (tun.  propria  s.  nerved)  of  a  whitish  and  wrinkled 
(rugous)  appearance,  with  long  folds  beset  with  oblong  mucous  glands  and 
pavement  epithelium.  The  oesophagus  is  surrounded  externally  by  lymphatic 
glands  (gland,  mediastince  postic.}. 

Vessels :  Artt.  cesophagea  come  to  the  cervical  portion  from  thyreaid.  infer.  • 
to  the  thoracic  :  1,  direct  from  the  Aorta  ;  2,  from  bronchiales;  3,  from  inter- 
cost  ales  (sometimes  mammaria  inierna ;  to  the  abdominal  portion:  from 
coronar.  ventric.  and  phrenica  inferior. 

Veins  correspond  to  the  arteries,  and  open  besides  into  Ven.  cava.  sup.  and 
azygos.  Lymphatic  vessels  enter  the  numerous  glands  around  the  (Esophagus. 

Nerves:  vagus  and  ganglia  thoracica  of  nerv.  sympathicus ;  form  plexuses 
before  and  behind  the  assophagus. 

b.  Parts  below  the  Diaphragm. 
436.       1.  The  Stomach,  ventriculus,  stomachus, 

a  membranous,  curved  sac,  the  shape  of  a  flattened  cone,  which 
is  situated  transversely  in  the  superior  region  of  the  abdomen, 
below  the  diaphragm,  filling  up  the  left  regio  hypochondriaca, 
and  extending  as  far  as  the  right  (passing  through  the  reg.  epigas- 
trica). —  Direction:  oblique  from  above  downwards,  and  from 
left  to  right.  In  this  position  it  is  maintained  by  (Esophagus, 
Duodenum,  and  a  fold  of  Peritoneum  which  attaches  it  to  the 
Liver  and  Spleen. 

Parts  of  the  Stomach:  1.  Anterior  wall;  this  is  directed  for- 
wards and  somewhat  upwards,  covered  above  by  the  heart,  to  the 
left  by  the  six  last  ribs,  separated  by  the  Diaphragm,  to  the  right 
by  lobul.  quadrat,  of  the  liver,  and  before  by  the  anterior  ab- 
dominal parietes  (reg.  epigastrica). 

2.  The   posterior  wall  looks   downwards   and  backwards,  is 
placed  above  the  Colon  transversum,  before  the  Duodenum  and 
Pancreas;  and  rests  upon  Mesocolon  transvers.    * 

3.  Curvatura  Major,  that  is,  the  inferior  convex  border  which, 
in  the  distended  stomach,  looks  forwards,  and  to  which  the  two 
anterior  laminae  of  the  great  omentum  are  attached  (at  this  point 
Jlrtt.  gastro-epiploicse). 

4.  Curvatura  Minor,  that  is,  the  superior  concave  border  be- 
tween Cardia  and  Pylorus.     In  the  full  stomach  it  looks  upwards 
and  backwards,  separated  from  the  vertebral  column  by  the  Aorta, 
and  Diaphragm ;  surrounds  the  small  lobes  of  the  liver,  the  tripus 
cxliacus  (Halleri)  [caeliac  axis]  and   plexus  Solaris;    to  it  is 
attached  the  small  omentum. 

5.  Fundus  ventriculi,  base  of  the  stomach.     This  includes 
the  entire  portion  of  the  stomach  situated  to  the  left  of  the  Cardia, 


THE  VISCERA.  207 

and  terminating  in  a  cul-de-sac.  It  is  round,  large  in  circum- 
ference, separated  by  the  Diaphragm  above,  from  the  lungs,  be- 
fore, from  the  six  last  ribs,  applied,  outwards,  against  the  spleen 
(thence  portio  splenica),  and  united  with  it  by  Lig.  gastro-spleni- 
cum  and  Vasa  breria ;  behind,  against  the  Pancreas,  left  Kid- 
ney, and  Caps,  supra-renalis. 

6.  Pars  pylorica,  at  the  right  extremity  of  the  stomach,  is 
bounded  at  its  junction  with   the   wider  central  portion  of  the 
organ  by  a  slight  contraction,  but  at  its  union  with  the  Duodenum, 
in  which  it  terminates,  by  a  stronger  ;  before  which,  at  the  dis- 
tance of  one  inch  from  the  stomach,  it  takes  a  considerable  curve 
(upwards),  and  forms  a  small  blind  sac ;  it  looks  to  the  right, 
backwards  and  upwards ;  lies  under  the  liver  and  the  small  omen- 
turn,  above  the  great,  before  the  Pancreas,  behind  the  abdominal 
walls  between  reg.  epigastrica  and  hypochondriaca  dextra  ;  not 
uncommonly  close  to  the  gall-bladder. — Pylorus  s.  ostium  duo- 
denale  is  situated  behind  the  lobulus  quadratus  of  the  liver,  leads 
into  the  Duodenum,  from  which  it  is  shut  out  (inwardly)  by  a 
valve,  valvula  pylori. 

7.  Cardia  s.  ostium  cesophageum,  the  mouth  of  the  stomach, 
lies  at  the  left  superior  portion  of  the  stomach  between  Curvatura 
minor  and  Fundus  ventriculi,  close  under  foram.  cesophag.  of 
the  Diaphragm  (with  lig.  phrenico-gastricum),  embraced  in  front 
by  the  left  border  of  the  liver,  behind  by  the  lobulus  Spigelii 
(behind  the    so-called    cardiac  fossa;    yet  not  always).     The 
width  of  Pylorus  and  of  Cardia  measures  about  one  inch. 

Structure  of  the  Stomach. 

a.  The  mucous  membrane,  villous  coat,  a  continuation  of  that  of  the  ceso- 
phagus,  forms  the  most  internal  coat  of  the  stomach.     Very  thin  and  exten- 
sible, thicker  and  more  solid  than  in  the  pars  pylorica;  it  presents  on  its  internal 
free  surface,  covered  with  thin  epithelium,  a  number  of  delicate  linear  eleva- 
tions, villi,  and  between  them  innumerable  openings  of  gastric  juice  glands 
(surrounded  by  pentangular  or  hexangular  vascular  meshes),  which  are  par- 
ticularly strongly  developed  in  the  pars  pylorica  :  on  the  Cardia  the  laminated 
glandul.  lenticulares.  which  do  not  open  upon  the  surface.     Besides  numerous 
folds  which  pass  from  the  Cardia  towards  the  Pylorus  longitudinally,  in  straight 
or  wavy  lines,  intersected  by  others  in  an  oblique  direction,  and  which  serve 
for  the  enlargement  of  the  stomach.     A  similar  circular  fold  of  mucous  mem- 
brane, between  the  layers  of  which  the  m.  sphincter  pylori  lies,  forms  the  Val- 
vula pylori. 

Besides  the  gastric  juice,  it  secretes  the  common  mucus. 

b.  T.  vasculosa  s.  nervea  is  connected  very  firmly  with  the  following,  and 
only  loosely  with  the  mucous  membrane. 

c.  T.  musculosa  consists  of  three  layers  of  pale  red  muscular  fibres : 

1.  The  external  layer,  formed  of  longitudinal  fibres,  which  spread  them- 
selves out  from  the  (Esophagus  upon  the  cardia,  and  thence,  in  a  radiated  form, 
upon  fundus  and  curvatura  major,  arranged  along  the  curvatura  minor  like  a 
band,  are  thicker  and  coarser  at  the  pylorus,  and  pass  over  upon  the  duodenum. 


208  SPECIAL  ANATOMY. 

2.  The  middle,  strongest  layer,  consists  of  circular  fibres,  which  pass  from 
the  (Esophagus  to  the  valvula  pylori,  and  terminate  in  the  last  with  a  thick  ring, 
as  m.  sphincter  pylori. 

3.  The  internal  layer  consists  of  oblique  fibres  (continuations  of  the  circular 
fibres  of  the  oesophagus),  which  pass  with  a  parabolic  curve  from  the  cardia, 
and  surround,  especially,  the  fundus. 

c.  Serosa,  the  most  external  coat,  is  firmly  attached,  at  some 
distance  from  the  curvatures,  to  the  muscular  coat ;  it  consists  of 
two  layers  of  peritoneum,  which  pass  from  the  liver  to  the  sto- 
mach at  the  curvatur.  minor,  cover  its  anterior  and  posterior 
surfaces,  unite  again  at  the  curvatur.  major,  and  form  at  this 
point  the  great  omentum  (see  Peritoneum). — Ligaments  :  omen- 
turn  minus  (gastro-hepatic.),  lig.  phrenico-gastricum,  splenico- 
gastricum. 

Vessels.  1.  Art.  at  the  small  curvature:  coronaria  ventric.  sinistra  (from 
A.  aeliaca)  ;  coron.  ventr.  dextra  (from  hepatica)  ;  on  the  great  curvature  :  gastro- 
epiploicce  (from  hepatica  and  lienalis)  ;  at  the  fundus  .-  Artr.  breves  (from  A. 
lienalis) ;  at  the  pyloric  end :  gastro-duodenalis.  2.  Veins,  the  same  names 
taking  a  like  course,  collect  in  V.  lienalis  and  coronar.  ventr.  dextra  and  open 
into  the  V.  porta.  Lymphatics :  pass  into  the  glands  along  both  curvatures. 

Nerves.  1.  N.  vagus  sinister,  forms  a  plexus  gastricus  on  the  ant.  surface; 
nerv.  vagus  dexter,  a  similar  on  the  posterior  surface  of  the  stomach ;  shortly 
(both)  around  the  Cardia,  and  they  are  lost  in  the  muscular  coat.  2.  Plexus 
cceliac,  formed  by  Nerv.  sympathicus. 

Development.  In  the  foetus  the  fundus  is  small,  the  whole  stomach  directed 
vertically ;  in  old  age  the  pyloric  portion,  and  especially  m.  pylori,  is  greatly 
developed. 

Function.  Chymification,  that  is,  the  metamorphosis  of  the  food  into  Chyme, 
by  means  of  the  acid  of  the  gastric  juice  (see  Pepsin). 

437.  2.  Intestinal  canal,  canalis  s.  ductus  intestinalis, 

a  tubular,  membranous,  greatly  convoluted  conduit,  reaching  from 
the  Pylorus  to  the  Anus,  and  filling  up  the  largest  portion  of  the 
lower  belly.  It  is  divided  into  a  superior,  longer,  and  at  the  same 
time  narrow  portion  (small  intestines),  and  an  inferior  and  also 
wider  (large  intestines).  Their  coats  are,  from  within  outwards. 
1.  Mucous  membrane.  2.  Tunica  propria  s.  nervea,  a  thin, 
brilliant,  white  uniting  tissue,  firmly  connected  to  the  mucous 
membrane  and  the  interposed  uniting  tissue  of  the  muscles,  and 
on  this  account  is  not  generally  expressly  mentioned.  3.  The 
muscular  coat,  consisting  of  an  internal  layer  of  delicate  circular, 
and  an  external  of  longitudinal  fibres  (according  to  Mussy  four 
layers).  4.  The  serous  coat  or  peritoneal  investment. 

438.     a.  The  small  intestine,  intestinum  tenue  s.  angustum, 

extends  from  the  regio  umbilicalis  and  hypogastrica,  through  the 
reg.  lumbalis  as  far  as  reg.  iliaca  dextra,  where  it  enters  the 


THE  VISCERA.  209 

commencement  of  the  large  intestine  (ca?cwm),  and  is  separated 
from  it  by  a  valve  (valvula  Bauhini}  [Ileo-csecal  and  Ileo-colic]. 
We  divide  it  into :  Duodenum  [equal  to  the  breadth  of  twelve 
fingers]  and  mesenteric  intestine  (that  is,  Jejunum  and  Ileum  as- 
sociated together).  The  small  intestine  is  distinguished  by  its 
greater  length  (fourfold),  its  narrowness,  and  its  structure,  from 
the  large. 

The  mucous  membrane  of  the  small  intestine  is  paler  than  that  of  the  sto- 
mach, and  presents  on  its  internal  free  surface,  valvula  conniventes,  villi,  and 
glands. 

1.  Valvula  conniventes  Kerkringii  consist  of  folds  of  the  mucous  membrane, 
inside  of  which  loose  uniting  tissue,  vessels  and  nerves  only  are  found.     They 
are  placed  vertically  to  the  axis  of  the  intestine,  form  one-half,  two-thirds,  or 
three-fourths  of  a  circle,  are  broadest  in  the  centre  (two  to  three  lines),  and 
lie  more  or  less  parallel,  close  to,  or  in,  the  empty  intestine,  in  an  imbricated 
manner  over  one  another.     They  commence  one  to  two  inches  below  the 
Pylorus,  increase  in  number  to  about  two-fifths  of  the  mesenteric  intestines, 
and  then  decrease,  until  at  the  termination  of  the  last  they  are  altogether 
wanting.     The  superficies  of  the  intestine  is  said  to  be  increased  by  their 
presence  about  two,  three,  or  even  six  fold. 

2.  Villi  (papilla)  cover  the  entire  small  intestine,  the  valv.  conniventes  as 
well  as  the  depressions  between  them.     Number:  undetermined;  4000  upon 
one  square  inch.     Length  =  0-2  to  0*8  of  a  line.     Shape:  foliaceous  (in  man), 
filiform  (in  the  dog,  cat)  ;  different  in  other  animals.     Structure:  each  villus 
consists  of  uniting  tissue,  like  the  papillae  of  the  corium  and  tongue,  extending 
into  a  sheath  of  Epithelium  (Henle) ;  but  containing,  instead  of  nervous  plex- 
uses, a  minute  ramification  from  the  lymphatic  rete,  surrounded  by  capillary 
vessels  (according  to  Lieberkxihn  a  cavity,  ampulla,  at  the  basis,  and  an  open- 
ing at  the  point,  from  which  the  Chyle- vessels  proceed).     The  absorption  of 
the  Chyle  in  all  probability  takes  place  without  an  opening  in  the  villus. 

3.  Glands:    a.    Gland,    solitaria,    simple   mucous   follicles,   are    dispersed 
through  the  whole  of  the  small  intestine ;  they  are  the  size  of  a  millet  seed, 
push  forward  the  mucous  membrane  beset  with  papillae,  are  hollow,  (gene- 
rally), closed,  but  surrounded  by  a  coronet  of  obliquely  placed  open  tubules 
(gland.  Lieberkuhnianaj?),  which  are  said  to  communicate  with  their  cavity 
(Krause).     They  contain  a  clear,  white,  or  granular  substance,  and  are  some- 
times open,  in  a  congested  condition,  appearing  then  as  inversions  of  the  Mu- 
cosa  (Henle). 

b.  Gland.  Peyeriante  are  distinguished  from  the  solitary,  merely  by  their 
occurring  in  masses  (gl.  agminatce),  and  possessing  thinner  walls  which,  like 
those  of  the  latter,  are  also  structureless.     These  accumulations  of  glands  are 
elliptical,  lying  in  the  longitudinal  axis  (of  the  small  intestines)  on  the  convex 
border,  opposite  to  the  attachment  of  the  mesentery;  particularly  abundant  at 
the  termination  of  the  Ileum,  decreasing  in  number  towards  the  Duodenum. 
They  are  also  surrounded  by  a  coronet  of  tubules,  and  are  sometimes  open. 

c.  Gland.    Brunnerianee  (pancreas   secundarium)  are    flat,   oval,  lenticular, 
racemose  glands,  divided  into  lobules  (gl.  acinorum  composite),  which  project 
more   outwardly   than    towards   the   mucous   membrane.     Disseminated  in 
masses  they  are  found  in  the  pars  horizont.  super,  of  the  duodenum,  but  only 
singly.     They  open  with  wide  mouths. 

14 


210  SPECIAL  ANATOMY. 

d.  Gland,  s.  cryptte  Lieberkuhniana  are  very  small  eversions  of  the  mucous 
membrane  externally,  which  give  to  the  last  a  cribriform  appearance,  lie  be- 
tween the  basis  of  the  villi,  and  are  said  to  contain  the  commencements  of 
the  lymphatics. 

439.  a.  Duodenum,  the  bile  intestine,  equal  in  length  to 
about  the  breadth  of  twelve  fingers  (eight  to  eleven  inches),  com- 
mences at  the  Valvula  pylori  and  terminates  without  any  definite 
boundary  line  to  the  left  of  the  lumbar  vertebrae,  behind  the  art. 
and  ven.  mesenterica  superior.  Figure  :  in  the  form  of  a  horse- 
shoe, with  the  concavity  directed  to  the  left,  in  which  we  find 
the  head  of  the  Pancreas. 

1.  The  superior  portion,  pars  horizontalis  superior,  about  two 
inches  long,  passes  to  the  right  and  backwards,  from  the  pylorus 
to  the  neck  of  the  gall  bladder,  which  lies  over  it  and  is  attached 
to  it  by  a  fold  of  peritonaeum.     It  is  more  moveable  than  the  fol- 
lowing parts.     Before  it  lie  the  lig.  gastro-colic.  and  the  abdom. 
ivalls.     Behind  it,  Vasa  hepatica  and  lig.  gastro-hepatic. 

2.  The  descending  portion,  p.  descendens  (s.  renalis],  two  to 
two  and  a  half  inches  long,  describes  above,  with  the  last  portion, 
an  acute  angle,  descends  vertically  rather  to  the  left  (of  first  to 
fourth  lumbar  vert.),  behind  the  right  extremity  of  the   Colon 
transv.,  crossing  with  it,  before  the  concave  border  of  the  right 
kidney,  close  to  Ven.  cava  and  duct,  choledochus.     Below  the 
centre  of  the   posterior  internal  surface  the  duct,  choledoc.  and 
pancreat.  open  into  it.     On  its  right  side,  Colon  ascendens;  on 

the  left,  the  head  of  the  Pancreas. 

3.  The  inferior  portion,  p.  horizontalis  inferior,  passes  off  at 
a  right   angle  with  the  last  portion  backwards   and  to  the  left, 
separated,  before,  from  the  stomach  by  a  layer  of  omentum  ;  be- 
hind, from  the  vertebral  column  by  the  Jlorta,  V.  cava,  and  the 
crura  of  the  Diaphragm  ;  along  its  superior  border,  Pancreas ;  at 
the  inferior  border,  meso-colon  transversum. 

Structure,  a.  The  mucous  membrane  of  the  Duodenum  is  distinguished 
from  that  of  the  rest  of  the  small  intestines  by : 

1.  In  the  pars  horizontal,  sup.,  the  valv.  conniventes  are  wanting. 

2.  The  villi  are  cup-shaped,  or  in  the  form  of  a  chaplet. 

3.  Gland.  Brunner.  predominate,  especially  in  the  superior  half,  and  are 
lost  at  the  inferior  extremity,  where  they  pass  as  gland,  solitarice  over  the  rest 
of  the  small  intestines. 

4.  Gland.  Peycriante  are  (almost)  entirely  wanting. 

5.  On  the  posterior  internal  wall  (at  the  inferior  extremity)  we  find  the 
opening  of  duct,  choledochus  and  pancreaticus  united  together  or  separate  (diverti- 
culum  Vateri). 

b.  The  muscular  coat  is  thicker  in  the  Duodenum  than  in  the  remainder  of 
the  small  intestine. 

c.  The   serous   (Peritonfeurn)  covers   the  p.  horizontal,   super.,  above  and 
below  only,  and  passes,  in  front,  into  the  large,  behind,  into  the  small  omen- 


THE  VISCERA.  211 

turn;  the  descending  and  inferior  portions  are  only  covered  by  it  in  front, 
their  posterior  surface  being  attached  by  uniting  tissue  to  the  parts  lying  be- 
hind. The  Duodenum  is  therefore  little  moveable. 

Vessels :  Art.  and  Ven.  gastro-dttodenalis  (from  the  Hepatica)  for  the  superior 
portion,  Art.  mesenterica  super,  for  the  inferior. — Lymphatics :  they  pass  into 
the  glands  above  the  Pancreas. 

Nerves :  they  come  from  Plex.  ccdiacus  and  hepatic. 

Function  of  the  Duodenum :  the  metamorphosis  of  the  Chyme  into  Chyle  by 
the  bile  and  the  succus  pancreaticus. 

440.  b.  The  Jejunum  (the  empty)  and  fleum  (the  convo- 
luted) mesenteric  intestine,  the  most  moveable,  attached  by  a  fold 
of  peritoneum  (mesenterium)  to  the  vertebral  column  and  the 
longest  portion  of  the  small  intestine,  passes  from  the  termination 
of  the  duodenum  at  first  backwards  and  forwards  and  from  right 
to  left,  winds  in  many  convolutions  (gyri)  through  the  reg.  umbi- 
licalis  and  hypogastrica  into  the  small  pelvis,  whence  it  ascends, 
lying  between  rectum  and  bladder,  transversely  from  left  to  right, 
and  (before  m.  psoas),  to  enter  vertically  the  large  intestine. 
Commencement:  to  the  left  of  the  second  lumbar  vertebra; 
termination  :  in  the  fossa  iliaca  dextra.  The  interval  between 
the  two  points  being  four  inches  in  length.  The  length  of  the 
mesenteric  intestine  measures  nineteen  feet;  the  width  in  the 
superior  part  =  6 — 4  inches,  in  the  centre  =  4 — 2,  at  the  terminal 
portion  =  3 — 5,  and  at  the  termination  itself  =  4 — 5.  The  greater 
the  width  the  more  deficient  in  length.  Shape  :  cylindrical.  To 
the  posterior  concave  border  the  mesenterium  is  attached.  The 
anterior  convex  border  is  separated  from  the  abdominal  parietes 
by  the  great  omentum.  Each  convolution  is  almost  entirely 
circular. — It  is  not  uncommon  to  find  at  the  inferior  part  of  the 
mesenteric  intestines  finger-shaped  appendages  (diverticula),  two 
to  three  inches  long,  which  occasion  hernix  (hernias  Littricse). 

Structure,     a.  The  mucous  membrane  is  distinguished  by : — 

1.  Valv.  conniventes  Kerk. 

2.  Glandul.  Peyeriame,  on  the  anterior  intestinal  wall. 

3.  Valvula  Bauhini  s.  Fallopia  s.  Tulpii  s.  Ileo-cacal  consists  of  a  fold  of 
mucous  membrane  which  projects  into  the  large  intestine  at  the  termination 
of  the  small,  becomes  reflected,  and  passes  over  upon  the  caecum.     Between 
the  two  layers  of  the  fold  (valve)  lie  circular  muscular  fibres.     The  ends  of 
the  valve  are  called  Frenula  Morgagni. 

[Another  fold  projects  towards  the  colon,  V.  Heo-colicJ] 

b.  The  muscular  coat  is  thinner  at  the  commencement  than  farther  down. 

c.  The  serous  coat  (Peritonaeum)  completely  covers  the  mesenteric  intes- 
tine, except  a  small  stripe  at  the  part  to  which  the  two  layers  of  the  mesen- 
tery are  attached. 

Vessels :  Art.  inlestinales  from  the  a.  mesenterica  super.  •  Veins :  they  open 
in  the  V.  mesenterica  major  (branch  of  Ven.  portaf)  •  the  Lymphatics  are  the 
Lacteals,  and  go  into  the  glands  of  the  mesentery. 

Nerves :  from  plexus  mesentericus. 

Function  of  the  mesenteric  intestine :  absorption  of  the  Chyle. 


212  SPECIAL  ANATOMY. 

441.  c.  The  large  intestine,  inteslinum  crassum  s.  amplum, 

extends  from  the  Valvula  Bauhini  as  far  as  the  Anus,  surround- 
ing the  small  intestine  almost  like  a  ring,  since  it  ascends  from  the 
inferior  part  of  reg,  iliaca  dextra  into  the  r.  hypochondriac  a  dextra 
as  high  as  the  liver,  passes  from  this  point  with  a  sudden  turn 
transversely  across,  below  the  stomach,  to  the  left  side  as  far  as  the 
spleen,  curves  once  more  and  descends  vertically  as  far  as  the  reg. 
iliaca  sinistra,  whence  it  sinks  down  into  the  small  pelvis  forming 
the  sigmoid  flexure,  and  terminates  with  the  rectum.  Its  length 
measures  four  to  five  feet,  its  width  varies  (see  below). 
Shape  :  tubular  with  irregular  surfaces. 

Structure  :  1.  Mucous  membrane,  whiter,  thicker,  and  coarser  than  that  of 
the  small  intestine,  contains  no  villi,  but,  instead,  irregularly  arranged  folds, 
between  which  numerous  mucous  glands  open  (gl.  Lieberkuhn.}  •  no  valvula 
conniventes,  but,  instead,  crescentic  transverse  and  longitudinal  folds. 

2.  The  muscular  coat  is  stronger  than  in  the  small  intestine. 

3.  Serous  coat  (Peritonauni)  less  complete  than  in  the  mesenteric  intestine ; 
the  Colon  transvers.  alone  has  a  complete  mesentery.     It  forms  in  several 
places,  especially  on  the  Colon,  semi-circular,  depending  folds,  beset  with  fat 
(appendices  adiposa  s.  epiploicte),  which  wind  around  and  tie  together  the  in- 
testine. 

Function :  For  the  formation,  keeping,  and  expulsion  of  the  faecal  matter. 
In  the  foetus  the  large  intestine  is  filled  up  with  meconium. 

442.  a.  The  Caecum, 

is  the  most  superior  portion  of  the  large  intestine,  ending  in  a 
cul-de-sac.  It  lies  in  the  fossa  iliaca  dextra,  covered  on  the  an- 
terior surface  only  by  peritonaeum,  and  therefore  little  moveable ; 
(it  nevertheless  sometimes  sinks  down  into  the  pelvis,  and  con- 
tributes to  form  hernias;)  generally  in  a  vertical  direction  (that  is, 
in  the  same  as  Colon  ascendens',]  next  to  the  stomach  the  thickest 
part  of  the  alimentary  canal ;  of  an  oblong,  sacciform,  and  irregular 
shape,  provided  below  (behind  and  to  the  left)  a  few  lines  beneath 
the  valv.  Bauhini  and  above  its  terminal  cul-de-sac,  with  a  pro- 
cess, proc.  s.  appendix  vermiformis  (one  to  six  lines  long),  about 
as  thick  as  a  goose-quill,  and  terminated  by  a  closed  end,  which  is 
attached  by  a  triangular  fold  of  peritonaeum  (mesenteriolum  ap- 
pendicis],  and  is  frequently  pushed  between  colon  ascend,  and 
kidney. 

In  front  the  caecum  touches  the  abdominal  parietes.  (The  small 
intestine  often  passes  between  them.) 

Behind  it  rests  upon  M.  iliacus  intern.,  separated  from  it  by 
fasc.  iliac o-lumb alis,  and  from  this  by  loose  uniting  tissue. 

Internally  the  Caecum  receives  the  small  intestine  at  an  obtuse 
angle  above. 


THE  VISCERA.  213 

Structure.  The  mucous  membrane  presents :  1.  Pocket-like  recesses  which 
correspond  to  the  elevations,  and  transverse  folds  corresponding  to  the  inden- 
tations on  the  outer  surface  of  the  intestine. 

2.  Valvula  Bauhini  s.  iko-c&calis  (see  small  intestine).     The  fold  which 
passes  from  the  Caecum,  has  entirely  the  characters  of  its  mucous  membrane. 
^Depressions,  or   alveoli,  are  seen  on  the  surface  of  the  m.  membrane  of 
Caecum.] 

3.  The  opening  of  the  vermiform  process. 

4.  The  muscular  coat  consists  of  longitudinal  fibres,  which  are  bound  up 
in  three  flat  stripes  (tera'<z)  as  broad  as  a  finger,  and  with  transverse  circular 
fibres,  by  which  the  vesicular  and  cellular  elevations  (cellula,  loculamenta)  are 
formed. 

5  Serous  coat  (jteriton<eum)  is  wanting  on  (upper  part)  the  posterior  surface 
of  the  intestine. 

Vessels:  branches  of  Jlrt.  and  Ven.  Heo-colica  (appendicularis,  £c.),  from  me- 
aenter.  superior. 

Nerves :  come  from  plexus  mesenteric.  sup. 

443.  b.  The  Colon, 

encircles  the  mesenteric  intestine  in  the  shape  of  a  horse-shoe, 
commencing  without  any  distinct  boundary  line  in  the  reg.  iliaca 
dextra,  making  a  first  curvature  in  the  reg.  hypochondriaca  dex- 
tra, a  second  in  the  reg.  hypochond.  sinistra,  and  a  third  in  the 
r.  iliaca  sinistra,  in  which  it  terminates  with  a  sigmoid  flexure. 
Hence  four  portions  arise. 

1.  Colon  ascendens  s.  dextrum  bounded  below  by  the  Caecum, 
terminates  as  high  as  the  gall  bladder;  is  covered  before  by  the 
peritonaeum  and  the  abdominal  walls  (from  which  it  is  sometimes 
separated  by  the  small  intestine),  behind  by  M.  quadrat,  lumb. 
and  the  right  kidney  (without  peritonaeum  and  only  fixed  to  the 
uniting  tissue).     On  the  inner  side  lie  small  intestines  (as  on  the 
external),  m.  psoas  and  p.  transv.  duodeni. 

2.  Colon  transversum  passes  off  at  a  right  angle  from  the  last, 
below  the  stomach  to  a  point  under  the  spleen,  is  convex  before, 
concave  behind,  and  very  moveable  (is  often  found  in  herniae).    It 
corresponds  above  with  the  liver  and  gall  bladder,  the  stomach 
and  the  inferior  extremity  of  the  spleen ;  below,  with  the  small 
intestines ;  before,  with  the  abdominal  walls  (separated  from  it  by 
the  two  anterior  layers  of  the  great  omentum) ;  behind,  with  the 
mesocolon  transv.  (mesentery,  by  which  it  is  separated  from 
Doudenum  and  Pancreas). 

3.  Colon  descendens  s.  sinistrum  passes  first  backwards,  then 
forwards,  on  the  posterior  abdominal  wall,  before  m.  quadrat, 
lumbor.  and  left  kidney;  commences  rather  deeper  than  1.,  and 
terminates  in  the 

4.  Sigmoid  flexure,  s.flexura  iliaca,  which  lies  in  the  fossa 
iliaca  sinistra,  before,  covered  by  the  abdominal  walls  (in  a  state 


214  SPECIAL  ANATOMY. 

of  distension),  at  the  sides  by  the  small  intestines ;  is  attached, 
behind,  by  mesocolon,  and  is  very  moveable.  At  the  commence- 
ment it  rises  somewhat  upwards  and  backwards  (to  muse,  iliac, 
intern,  sinist.),  then  descends  vertically ;  the  termination  curves 
right  or  left,  forwards  or  backwards  as  high  as  the  basis  oss.  sacri, 
where  the  rectum  commences. 

Structure.  The  external  surface  of  the  Colon  presents,  like  that  of  the 
Caecum,  the  tatnia,  and  loculamenta.  On  the  Colon  descend,  and  Sigmoid  flexure 
there  are  only  two  rows  of  elevations;  these  disappear  lower  down. 

Mucous  and  muscular  coat  (see  large  intest). 

Serous  coat  (peritonaurn)  covers  the  colon  ascendens  and  descendens  on  the 
anterior  wall,  only,  on  which  account  the  last  is  little  moveable.  On  the  con- 
trary the  Colon  transfers.,  completely  enveloped  (inesocolon  trans.),  and,  like 
sigmoid  flexure,  is  very  moveable. 

Vessels :  For  colon  ascend,  and  right  half  of  transv.  branches  of  Art.  mesente- 
rica  superior,  Ven.  mesent.  major  •  for  the  remainder  of  the  Colon:  Art.  mesent. 
infer,  and  Ven.  mesent.  minor. 

Lymphatics :  open  into  the  glands  on  the  attached  border. 

Nerves :  Branches  ofpkx.  mesentericus  sup.  et  inferior. 

444.  c.  The  Rectum, 

the  most  inferior  part  of  the  intestinal  canal,  lies  on  the  posterior 
wall  of  the  lesser  pelvis  in  the  curvature  before  the  sacrum  and 
coccyx,  commencing  to  the  left  of  basis  oss.  sacri,  and  terminating 
with  the  anal  opening,  anus,  under  fundus  vesicse  (or  vagina  in 
the  female),  surrounded  and  attached  all  round  by  uniting  tissue. 
Curved,  in  front  concave  and  behind  convex,  it  inclines  at  the 
apex  of  the  coccyx  rather  backwards,  and  is  removed  from  the 
vagina  (in  the  female)  and  from  the  urethra  (in  the  male).  Pos- 
terior surface  :  above  to  the  left,  before  the  Symphys.  sacro-iliaca 
sinistra,  separated  by  m.  pyramidalis,  plex.  sacral,  and  vasa 
hypogastrica,  attached  by  mesorectum,  below  to  the  left  of  os 
coccyg.,  covered  by  m.  levator  ani.  From  its  middle  (on  three 
false  vertebrae  of  the  sacrum)  to  its  termination  before  the  middle 
line.  The  anterior  surface  (above  free)  corresponds  in  the  male : 
1.  To  the  posterior  surface  of  the  urinary  bladder  (from  which  it 
is  separated,  when  filled  up,  by  the  small  intestines),  below  to  the 
tindus  vesicse  (separated  by  the  two  vesicul.  seminales).  2.  The 
Prostata,  which  projects  over  one  of  the  two  sides  or  both.  3. 
The  pars  membran.  urethras  (separated  by  a  triangle,  the  apex 
backwards  and  upwards).  In  the  female:  1.  The  superior  free 
portion,  the  lig.  latum,  Ovarium,  tuba  Fallopise  sinistra,  Uterus 
and  Vagina.  2.  The  inferior  part  close  behind  Vagina. 

At  the  sides  are  situated,  above,  small  Intestines,  below,  uniting 
tissue. 

Structure.     1.  The  mucous  membrane  is  stronger  and  more  red  than  in 


THE  VISCERA.  215 

the  rest  of  the  intestines  ;  it  presents  longitudinal  folds  (column*  rugarum  recti) 
which  disappear  by  distension;  besides  at  the  commencement  and  anus  a 
circular  fold  (plica  annularis). 

2.  The  muscular  coat,  like  the  mucous,  is  similar  to  that  of  the  (Esophagus  ; 
it  forms  m.  sphincter  ani  internus. 

3.  The  serous  coat  (peritoneum)  covers  the  anterior  surface  (of  the  supe- 
rior half  only).     From  the  promontorium  to  the  rectum  there  is  a  fold;  this.  is, 
meso-rectum. 

Vessels:  A.  heemorrhoidalis  interna  (from  Jl.  mesent.  infer.'),  hamorrh.  med. 
(from  hypogast.),  hcemorrh.  inferior  (from  pudenda  intern.}.  —  Vv.  form  pkx. 
hamorrh.,  from  which  arise  Vv.  hamorrh.  (connection  with  Ven.  portte).  — 
Nerves  :  branches  from  plex.  hypogastricus  and  sacralis  (for  voluntary  motion), 
and  of  N.  sympathicus  (for  involuntary). 


The  JlnuS)  Orificium 

a  narrow  fissure,  dilating  in  a  circular  form,  lies  in  the  central  line  at  the  pos- 
terior part  of  the  perinaeum,  one  inch  in  front  of  the  coccyx,  between  the 
tuberosities  of  the  Ischia,  and  is  generally  closed.  Its  skin  is  brownish,  rich 
in  sebaceous  glands  (in  the  male  beset  with  hair),  and  passes  in  wrinkles  into 
the  mucous  membrane  of  the  rectum.  —  Muscles:  see  sphincter  and  lev.  ani.  — 
Arteries:  branches  of  Hcemorrhoidales.  —  Veins:  very  numerous,  convoluted, 
plexiform  ;  the  most  external  roots  of  ven.  portarum.  —  Nerves  :  numerous  from 
plex.  sacralis  and  sympathicus. 

Meconium,  a  thick,  viscous,  scentless,  dark  green  mass,  fills  the  large  intes- 
tine of  the  foetus,  and  the  younger  the  subject  so  much  the  more  in  quantity. 
In  the  small  intestine  we  find,  instead  of  it,  a  thin,  yellow,  sometimes  colour- 
less mucous  fluid. 

445.       Appendages.     1.  The  Liver,  Hepar,  Jecur. 

The  liver  is  a  glandular  organ,  for  the  purpose  of  secreting  bile. 
Very  large,  oblong,  quadrangular,  it  lies  close  under  the  dia- 
phragm, enveloped  by  peritonaeum,  protected  externally  by  the 
seventh  and  eighth  last  ribs,  in  reg.  hypochond.  dextra,  and 
reaches  in  a  transverse  and  oblique  direction  as  far  as  reg.  hypo- 
chond. sinistra.  Weight  :  four  to  five  pounds.  Transverse  diam.  : 
ten  to  twelve  inches.  Length  (from  behind  forwards)  :  six  to 
seven  inches.  Thickness  :  four  to  five  inches.  Spec.  grav.  :  1*5. 

a.  Surfaces.  1.  The  superior  surface,  pars  gibba,  smooth,  convex,  to  the 
left  more  flat,  lies  close  under  the  vault  of  the  diaphragm,  and  before  on  the 
abdominal  walls,  divided  by  lig.  suspensorium  into  a  larger  right  and  a  smaller 
left  portion  (lobes).  They  are  separated  by  the  diaphragm  from  the  concave 
basis  of  the  right  lung,  from  the  heart,  and  from  the  (seventh  and  eighth  last) 
ribs  ;  touches  the  abdominal  walls  in  the  reg.  epigastr.  and  under  the  right 
short  ribs  (where  it  comes  forward,  especially  in  sitting,  when  the  body  is 
inclined  forwards). 

2.  The  inferior  surface,  pars  sima,  concave,  directed  backwards  and  out- 
wards, lies  over  the  right  kidney,  the  flexura  coli  dextra,  colon,  transfers.,  pars 
pylorica  ventriculi,  duodenum,  and  small  omentum.  It  presents  in  the  centre 
two  longitudinal  grooves  (fossae  longitudinales),  which  are  united  by  a  trans- 
verse groove  (foss.  transv.  s.  Porto),  whereby  an  H-shaped  excavation  is  formed, 


216  SPECIAL  ANATOMY. 

and  the  inferior  surface  is  at  the  same  time  divided  into  four  lobes,  viz.,  a  left, 
an  anterior  central,  a  posterior  central,  and  a  right  lobe. 

REMARK.  Many  anatomists  distinguish  only  a  right  (six  times  larger  than 
left)  and  a  left  inferior  lobe,  the  boundary  between  them  being  the  left  longi- 
tudinal fissure. 

a  a.  The  lobes.  1.  The  left  lobe  of  the  liver,  lobus  hepaticus  sinister,  smaller 
(also  on  the  superior  surface)  than  the  right,  lies  on  the  left  side  of  the  H,  is 
before  concave  (for  the  convexity  of  the  stomach),  as  well  as  behind  (for  the 
lobul.  Spigelii,  which  the  small  omentum  separates  from  it).  It  reaches 
sometimes  as  far  as  the  Spleen. 

2.  Anterior  central,  lobulus  quadratus,  before  the  transverse  fissure,  in  the 
centre  of  the  H,  quadrangular,  small,  terminates  behind  (frequently),  nipple- 
shaped. 

2.  Posterior  central  lobe,  lobulus  Spigelii  s.  caudatus,  behind  the  transverse 
fissure,  between  the  posterior  part  of  the  right  and  left  lobes  of  the  liver,  to 
the  right  of  the  Cardia,  on  the  Curvatura  minor ;  flat,  crescentic,  convex  on 
the  free  inferior  border,  which  corresponds  to  the  superior  border  of  the 
Pancreas;  in  the  centre  provided  with  a  tubercle,  tuberculum  papillare  s. 
triangulare,  surrounded  by  an  anterior  vascular  ring  (jt.  coronar.ventric.,  hepatic., 
spknicd)  ;  a  small  longitudinal  projection  (tuberc.  caudatum)  passes  on  the  an- 
terior part,  obliquely,  from  the  Porta  to  the  right  lobe,  forwards,  and  separates 
the  impressio  renalis  from  the  impress,  colica. 

4.  Right  lobe  of  the  liver,  lobus  dexter,  smaller  than  upon  the  superior 
surface,  to  the  right  of  the  two  last  described,  separated  from  it  by  the  right 
longitudinal  fissure,  thicker  than  the  left  lobe,  presents  behind  an  impressio 
renalis,  to  which  is  applied  the  superior  third  or  half  of  the  right  kidney, 
and  before  an  impressio  colica,  for  the  flexura  coli  dext.,  and  sometimes  the 
duodenum. 

bb.  Fossae  or  fissures:  1.  The  transverse  fossa,  porta,  porta  s.  sinus  vena: 
porta  (hilus  hepatis),  lies  rather  behind  the  centre,  between  the  two  longitudi- 
nal fossa?,  and  separates  the  lobulus  quadratus  from  /.  Spigelii;  is  fifteen  to 
eighteen  lines  long  and  deep.  It  contains:  Vena  portce,  Art.  hepatica,  the  roots 
of  ductus  hepaticus,  numerous  lymphatics,  pkx.  hepaticus  from  Nerv.  sympathi- 
es, surrounded  by  uniting  tissue,  capsuli  Glissonii.  Here  commences  also  the 
lig.  gastro-hepaticum. 

2.  The  right  longitudinal  fossa : 

a.  Anterior   half,  fossa  vesica  felkte,  lies   between    lobus    dexter   and 
quadratus;  is  not  deep,  and  does  not  reach  so  far  as  the  anterior  border 
of  the  liver ;  receives  the  gall  bladder. 

b.  Posterior  half,  fossa  ven.  cava,  is  sometimes  closed  in  the    form 
of  a  canal ;  it  contains  the  inferior  Ven.  cava,  into  which  the  hepatic  veins 
open. 

3.  The  left  longitudinal  fissure  : 

a.  Anterior  half,/ossa  umbilicalis,  is  sometimes  closed  up  like  a  canal, 
lies  between  lobus  sinister  and  quadratus,  and  contains :  the  umbilical 
vein  of  the  Embryo  (that  is,  lig.  teres,  after  birth). 

b.  Posterior  half,/ossa  ductus  venosi,  between  lobus  sinister  and  Spigelii; 
containing  in  the  embryo  the  ductus  venosus  Jlrantii,  which,  connected  with 
the  umbilical  cord  and  the  left  branch  of  the  ven.  portce,  the  blood  of  which 
it  carries  into  the  vena  cava  inf.,  sinks  behind  lob.  Spigelii  into  Ven.  cava 
inferior.     It  is  obliterated  after  birth. 


THE  VISCERA.  217 


c.  The  Borders.  1.  The  anterior  border  is  thin,  sharp,  oblique  from  below 
upwards,  and  directed  from  right  to  left;  it  presents  to  the  left  a  deep  in- 
cision, incisura  interlobularis,  where  Kg.  teres  (  V.  umbilicalis)  lies ;  farther  to  the 
right  a  notch,  at  which  point  \he  fundus  vesicte  fetteae  is  seen;  it  projects  under 
the  cartilages  of  the  seventh  to  the  tenth  ribs  into  the  epigastrium. 

2.  The  posterior  border  is  short  and  obtuse,  rounded,  attached  to  the  dia- 
phragm, being  connected  by  uniting  tissue ;  to  it  the  lig.  coronar.  hepatis  a'ttaches 
itself  from  the  diaphragm  above  and  underneath.  To  the  left  a  deeper  notch, 
for  Ven.  cava.  infer. ;  to  the  right,  for  ductus  venosus  Arantii.  The  right  ex- 
tremity of  the  liver  is  smooth,  rounded,  massive  (with  Kg.  triangular,  dexter.)  ; 
the  left  extremity  terminates  in  an  angular  or  obtuse  process  (with  lig.  triangul. 
rinistrum'). 

Structure.  The  proper  substance  (Parenchyma)  of  the  liver  is  reddish  or 
yellow ;  in  other  persons,  darker  (of  a  clouded  colour,  between  olive  green 
and  chamois) ;  close  and  lacerable.  It  divides  into  lobes,  lobules,  and  gland 
granules,  acini;  these  are  accumulations  of  closed,  yellow,  nucleated  cells,  two 
to  three  lines  long,  half  a  line  thick.  The  acini  are  seated  like  vine  leaves 
upon  pedicles,  which  are  ramifications  of  the  vena  hepatica,  which  spreads 
itself  out  in  their  axis  like  the  veins  of  a  leaf.  The  surface  of  the  acini  is 
surrounded  by  a  capillary  network  of  the  most  delicate  branches  of  vena 
portee,  "which  are  in  connection  with  ven.  hepatica.  From  the  blood  of  the 
ven.  porta  the  elements  of  the  bile  pass,  probably,  into  the  closed  nucleated 
cells ;  but  the  connection  of  these  with  the  biliary  passages  (ducts)  has  hitherto 
remained  unexplained.  The  ducts  are  best  considered,  with  Henle,  as  in- 
tercellular passages,  which  at  first  appear  between  the  acini.  The  lobes  and 
lobules  are  connected  by  uniting  tissue,  which  enters  in  from  the  surface. 
The  particular  elements  of  the  liver  are: 

Membranes:  1.  The  serous  covering  (PeritoiuKwri)  of  the  liver  covers  it  as 
far  as  that  part  of  the  posterior  border  which  is  attached  to  the  diaphragm, 
and  to  the  floor  of  the  grooves.  From  it  the  following  folds  pass  off:  lig. 
coronarium  and  suspensorium,  lig.  hepatico-gastricum,  duodenale,  and  renale. 

2.  A  fibrous  investment  covers  the  entire  liver;  is  connected  on  its  exter- 
nal surface  with  the  serous  coat;  in  the  interior,  with  the  parenchyma.  It 
shows  itself  most  distinctly  in  the  porta,  where  it  forms  sheaths  for  the 
vessels,  that  is,  Capsula  Glissonii,  and  cells  for  the  lobes  and  lobules,  since 
prolongations  extend  from  it  into  the  interior  of  the  organ. 

Vessels:  1.  Vena  portte  forms  a  trunk  in  the  Porta,  from  which,  after  the 
manner  of  arteries,  right  and  left  branches  pass  off,  which  ramify  through  all 
parts  of  the  interior  of  the  liver,  dividing  at  acute  angles,  but  not  dichoto- 
mously,  in  a  transverse  direction,  and  are  surrounded  by  sheaths  of  the 
Capsula  Glissonii.  Its  capillary  rete  surrounds  the  acini,  and  passes  over  into 
the  commencement  of  the  hepatic  veins. 

2.  Art.  hepatica,  a  (small)  branch  of  art.  caeliaca,  passes  with  the  portal  vein 
and  the  biliary  canals.     Its  capillary  rete  spreads  out  upon  the  parietes  of  the 
vessels  and  biliary  ducts  almost  exclusively,  and  unites  with  the  rete  of  the 
portal  vein. 

3.  Vena  hepatica:,  which  arise  in  all  points  of  the  liver  as  Venute  centrales, 
pass  (in  opposite  directions  from  the  lobes  1,2,  and  4)  backwards  towards 
Ven.  cava  infer.,  to  which  they  convey  the  blood  from  the  portal  vein,  and 
from  Art.  hepatica.     (They  are  without  sheaths,  and  therefore  remain  patent 
when  divided  transversely.) 

4.  The  biliary  passages,  ductus  biKferi,  are  narrow  canals,  which  terminate 
in  a  cul-de  sac  (?),  spreading,  like  the  branches  of  a  tree,  through  the  liver, 


218  SPECIAL  ANATOMY. 

are  surrounded  by  a  network  of  the  capillaries  of  the  ven.  porta  and  hepatic 
artery,  and  pass  together  into  two  large  ducts  (which,  coming  from  the  right 
and  left  hepatic  lobes,  and  covered  in  the  porta  by  sheaths  of  the  Capsula 
Glissonii,  unite  together).  According  to  E.  H.  Weber's  latest  researches,  they 
form,  like  the  blood-vessels,  an  uninterrupted  and  just  as  close  rete,  the  inter- 
spaces being  filled  up  with  the  vessels,  so  that  the  two  together  produce  the 
hepatic  parenchyma;  in  the  porta,  blindly  ending  vasa  aberrantia  of  the  liver 
are  present. 

5.  Lymphatics:  very  numerous ;  first  discovered  in  the  liver;  they  open, 
partly,  directly  into  the  ductus  thoracicus. 

Nerves:  1.  Branches  of  Vagus.     2.  Plexus  hepaticus  N.  sympath. 

446.  Apparatus  for  the  excretion  of  the  Bile. 

a.  The  bile  duct,  ductus  hepaticus  s.  excretorius  hepatis, 

arises  by  the  association  of  the  two  biliary  ducts  before  mentioned, 
is  from  one  to  one  inch  and  a  half  long,  and  from  two  to  two  and 
a  half  lines  thick.  It  passes  out  from  the  Porta  behind  the  right 
branch  of  Art.  Hepatica,  passes  downwards  and  backwards  in  the 
lig.  gastro-hepatic.,  and  divides  into  two  ducts,  one  of  which,  the 
left,  ductus  cysticus,  leads  into  the  gall  bladder,  the  right,  ductus 
choledochus,  into  the  Duodenum.  Situation :  to  the  right  of  art. 
hepatic.,  to  the  left  of  ductus  cysticus;  before  ven.  portse. 

447.  b.  The  gall-bladder  cystis  s.  vesica  fellea,  is  a  pear- 
shaped  sac,  three  to  four  inches  long,  situated   on  the   inferior 
surface  of  the  liver,  in  the  fossa  cystica,  it  extends  obliquely  from 
before  backwards,  from  below  upwards,  and  from  right  to  left, 
contains  about  eight  to  nine  drachms. 

We  distinguish : 

a.  The  fundus,  the  closed  globular  extremity  which  projects 
at  the  anterior  border  of  the  liver,  touching,  in  that  place,  the 
abdominal  walls  (to  the  outer  border  of  m.  rectus,  close  to  the 
anterior  extremity  of  the  tenth  rib).     Behind,  the  fundus  of  the 
gall  bladder  passes  into  the  conical. 

b.  Body,  corpus.     This  rests  below  upon  the  pars   super, 
duodeni  and  the  right  extremity  of  the  colon,  transv.  (not  un- 
commonly also  upon  the  right  kidney  or  upon  the  pylorus). 
Above  it  is  attached  by  loose  uniting  tissue  to  the  liver. 

c.  The  neck,  collum,  is  twisted  like  a  screw.    It  lies,  generally, 
to  the  left,  and  passes  under  the  Porta  into  the  ductus  cysticus, 
at  which  point  a  contraction  marks  the  limit  between  them,  as 
occurs*  also,  at  its  junction  with  the  body. 

Membranes.  1.  A  serous  membrane  (Peritonaum)  covers  the  inferior  sur- 
face, only,  of  the  gall  bladder. 


THE  VISCERA.  219 

2.  A  fibrous   (muscular)  coat,  consisting  of  an  internal  stronger  layer  of 
longitudinal  fibres,  and  an  external  of  circular,  similar  to  that  of  the  vessels, 
is  united  with  the  serous  by  areolar  tissue,  is  little  extensible,  and  connected 
with  the  muscular  coat  of  the  intestinal  canal. 

3.  Mucous  membrane,  villous,  with  short  irregularly  crossing  folds  (like  a 
net),  beset  with  tn'tfi,  greyish  white,  coloured  yellow  by  the  bile,  presents  at 
the  neck  (where  externally  we  remark  the  screw-like  appearance)  two  small 
valves,  but  which  assist  neither  the  entrance  nor  the  exit  of  the  bile.     (The 
space  between  the  two  is  sometimes  expanded  like  a  sac,  where  gall-stones 
men  form.)     The  internal  surface  is  covered  with  cylindrical  Epithelium. 

Vessels:  jlrt.  cystica  from  ram.  dext.  art.  hepaticce.  Ven.  cystica  passes  into 
the  right  branch  of  Ven.  porta.  Lymphatics:  very  numerous,  sometimes 
coloured  yellow,  pass  into  plex.  portarum  and  gland,  cceliacce.  Nerves:  from 
plexus  hepaticus. 

Function:  The  gall  bladder  preserves  the  bile  brought  to  it  through  ductvs 
hepaticus  and  cysticus  for  a  time,  and  is  again  emptied  through  ductus  cysticus 
and  choledockus. 

Bile  (see  10). 

448.  c.  The  duct  of  the  gall-bladder,  ductus  cysticus, 

the  continuation  of  the  neck  of  the  gall  bladder,  from  which  it 
passes  downwards  and  to  the  left,  is  thinner  and  shorter  than  the 
hepatic  duct,  passes  downwards  upon  the  right  side  of  ductus 
hepaticus,  and  unites  with  this  at  a  very  acute  angle  in  the  d. 
choledochus.  Situation:  in  the  lig.  hepatico-duodenale,  before 
ven.  cava  inferior,  to  the  right  of  art.  cystica, 

449.  d.  The  common  bile  duct,  ductus  communis  choledochus, 

formed  by  the  united  ductus  cysticus  and  hepaticus,  passes  in 
the  same  direction  as  the  last,  obliquely  downwards,  rather  back- 
wards and  to  the  right,  has  a  thickness  equal  to  a  moderate  goose- 
quill,  and  a  length  of  from  two  to  two  inches  and  a  half.  At  the 
superior  part  it  lies  in  the  lig.  hepatico-duodenale,  before  ven. 
portse,  below  art.  hepatica,  along  the  right  side  of  art.  gastro- 
epiploica  dextra,  surrounded  by  uniting  tissue  and  lymphatic 
glands ;  then  behind  and  on  the  internal  border  of  the  pars  descend, 
duodeni  in  a  groove  on  the  head  of  the  Pancreas;  lastly,  it  per- 
forates very  obliquely  the  muscular  coat  of  pars  descend,  duodeni 
at  its  centre,  passes  six  or  seven  lines  between  the  muscular  and 
mucous  coat,  on  the  right  side  of  duct,  pancreaticus,  perforates 
the  mucous  membrane  on  the  internal  wall  of  the  inferior  portion 
of  the  pars  desc.  duodeni  with  a  round  opening  (so  that  a  retro- 
grade course  of  the  bile,  &c.,  is  impossible),  after  having  received, 
shortly  before,  the  duct,  pancreatic. 

Structure.     It  is  like  the  duct  of  the  gall  bladder. 


220  SPECIAL  ANATOMY. 

450.         2.  Abdominal  salivary  gland,  Pancreas. 

This  is  a  long,  flat,  greyish  white  gland,  which  is  placed  trans- 
versely behind  the  greater  curvature  of  the  stomach,  before  the 
twelfth  dorsal  and  first  lumbar  vertebra,  and  extends  from  the  con- 
cavity of  the  duodenum  as  far  as  the  spleen.  In  length:  seven 
to  eight  inches;  thickness:  half  to  one  inch;  breadth:  one  and  a 
half  to  two  inches  and  three  quarters;  weight:  three  to  four 
ounces.  The  right  extremity  (caput,  extremitas  duodenalis), 
thick  and  broad,  lies  coiled  in  the  curvature  of  the  duodenum 
(and  on  the  ductus  choledochus) ;  partly  before  the  P.  horizontalis 
inferior  duodeni,  close  before  the  art.  and  ven.  mesenterica,  aorta 
and  v.  cava  infer.;  it  is  called,  when  separated  from  the  rest,  Pan- 
creas parvum  Winslowii. 

The  left,  splenic  extremity  (cauda)  is  narrow,  and  lies  on  the 
internal  surface  of  the  spleen. 

The  superior  thick  border  has  a  groove  for  art.  lienalis,  and 
looks  towards  the  pars  super,  duodeni,  lobul.  Spigelii  and  art. 
cceliaca.  The  inferior  border  lies  along  the  p.  horizontalis  duoden. 
infer.,  separated  to  the  left  by  art.  and  ven.  mesenterica  superior. 

The  anterior  convex  surface,  covered  by  the  peritonaeum,  looks 
towards  the  posterior  wall  of  the  stomach,  the  commencement  of 
the  duodenum  and  iheflexur.  coli  dextra. 

The  posterior  concave  surface  is  not  covered  by  peritonaeum ; 
separated  from  the  vertebra  by  V.  lienalis,  mesenterica  superior, 
and  commencement  of  Ven.  portx,  crurre  of  the  diaphragm,  V. 
cava  inf.  (on  the  right),  Aorta  (to  the  left).  To  the  left  of  the 
vertebral  column  it  rests  upon  the  caps,  supra  renales,  renal  ves- 
sels and  nerves.  The  Pancreas  follows  the  movements  of  the 
Duodenum. 

The  excretory  duct,  duct,  pancreaticus  seu  Wirsungianus,  arises  in  the  splenic 
end,  by  the  conjunction  of  several  canaliculi  which  come  from  the  lobules  of 
the  gland,  always  becoming  wider,  as  all  the  canaliculi  open  directly  into  it, 
and  passing  in  the  central  part  of  the  gland  to  the  right  extremity,  where  it 
makes  its  exit,  lying  to  the  left  of  the  ductus  choledochus,  which  it  perforates, 
and  opens  in  common  with  it  in  the  pars  descend,  duodeni.  Its  walls  are  very 
thin,  extensible,  milk-white,  and  inwardly  smooth.  Two  pancreatic  ducts 
are  frequently  present,  one  of  which  opens  in  an  isolated  manner  into  the 
duodenum. 

Structure:  The  Pancreas  consists,  like  the  salivary  glands,  of  conglomerated 
lobules  connected  together  by  uniting  tissue,  these  again  of  vesicles  (acini),  in 
which  the  canaliculi  commence. 

Vessels:  Art  et  Ven.  are  branches  of  lienalis,  pancreatico-duodenalis,  and 
mesenterica  superior. 

Nerves :  They  come  from  plexus  lienalis,  gastricus,  mesentericus  superior. 

Function :  Secretion  and  excretion  of  succus  pancreaticus  (that  is,  a  colour- 
less, transparent,  and  viscous  mucus,  in  which  we  find  soda,  common  salt, 
phosphate  of  lime). 


THE  VISCERA.  221 

451.  3.  The  Spleen,  lien,  spleen, 

a  spongy  organ  very  rich  in  blood  (blood  gland)  which  lies  deep 
in  the  reg.  hypochondr.  sinistra,  behind  and  to  the  left  of  the 
fundus  of  the  stomach,  above  the  left  kidney,  in  a  fold  of  the 
peritonaeum,  and  becomes  displaced  by  the  movements  of  the 
diaphragm  and  stomach.  Figure :  semi-oval  (also  prismatic). 
Colour:  bluish  or  brownish  red  or  even  pale  grey,  by  long 
exposure  to  the  air,  rosy  red.  Weight:  two  to  eight  ounces 
(in  hypertrophy  =  ten  to  thirty  pounds) ;  specific  grav. :  1*16. 
Length  :  four  to  five  inches  ;  breadth :  two  and  a  half  to  three 
and  a  half;  thickness  :  one  to  one  and  two-thirds. 

The  external,  convex,  smooth  surface,  separated  by  the  dia- 
phragm from  the  ninth  to  the  eleventh  ribs,  looks  upwards  and 
backwards. 

The  internal  concave  surface  looks  obliquely  forwards  towards 
the  Pancreas  and  fundus  of  the  stomach,  and  presents,  in  about 
the  centre,  a  superficial  oblong  excavation,  hilus  lienalis,  where 
the  splenic  vessels  enter  and  pass  out,  and  lig.  gastro-lienale  is 
attached.  Before,  the  hilus  is  in  contact  with  the  fundus  of  the 
stomach;  behind  that,  the  left  kidney  and  caps.  sup.  renales  and 
the  tail  of  the  Pancreas. 

The  superior  thick  extremity  lies  under  the  diaphragm  ;  the 
inferior  pointed  extremity  rests  upon  the  angle  of  the  colon 
(transv.  and  descend.).  The  borders  are  sometimes  deeply  in- 
dented, and  thus  present  traces  of  a  second  spleen  (lien,  succentu- 
riatus)  or  several,  which  in  the  foetus  and  children  are  frequently 
observed.  The  posterior  border,  thick  above,  is  adjacent  to  the 
kidney,  the  anterior  is  applied  to  the  stomach. 

Structure :  1.  The  proper  substance  of  the  spleen  is  a  pultaceous,  reddish 
brown,  granular  mass,  pulpa  lienis,  which  consists  of  pencillate  tuils  of  capil- 
lary vessels,  out  of  which  veins  pass,  and  which  lies  like  a  sponge  in  the 
whitish  cells  of  a  fibrous  membrane. 

2.  The  fibrous  coat,  tunica  allntginea,  forms  the  frame- work  of  the  organ, 
since  it  covers  it  externally,  and  sends  prolongations  into  the  Parenchyma, 
like  a  net,  especially  at  the  hilus,  where  it  forms  sheaths  for  the  vessels,  and 
accompanies    their    ramifications,   so   that    the    whole    acquires   a   spongy 
structure. 

White  splenic  corpuscles,  corpuscula  lienis  Malpighi  (not  to  be  confounded 
with  the  liquefying  vesicles  of  Herbivarcf),  lie,  according  to  J.  Muller,  inside 
the  red  granules  of  the  pulpa,  and  are  seated  upon  the  white  sheaths  of  the 
arterial  branches,  of  which  they  are  merely  sprouts  (according  to  Heusinger 
blastema,  formative  matter). 

3.  The  serous  tunic  (peritonaeum)  envelopes  the  whole  spleen,  even  to  the 
Hilus,  where  the  lig.  gastro-lienale  comes  over  from  the  fundus  of  the  stomach. 
Lig .  phrenico-lienak  goes  from  the  superior  extremity  of  the  spleen  to  the  pos- 
terior portion  of  the  inferior  surface  of  the  diaphragm.     Its  internal  surface  is 
firmly  connected  to  the  external  of  t.  albuginea. 


222  SPECIAL  ANATOMY. 

4.  Vessels:  a.  Art.  lienalis,  branches  of  cadiaca,  divides  into  four  or  five 
twigs,  each  of  which  supplies  one  or  the  other  independent  parts  of  the  spleen. 
b.   Ven.  lienalis,  the  principal  branch  of  the  ven.  porta,  four  or  five  times  larger 
than  the  JLrt.,  without  valves,     c.  Lymphatics :  they  go  into  the  glands  along 
the  hilus,  between  the  layers  of  lig.  gastro-lienale. 

5.  Nerves :  come  immediately  from  plex.  licsialis,  as  well  as  from  pi.  solans. 
Function:  The  preservation  or  alteration   of  the  blood  or  the  lymph  (?), 

according  to  Cruveilhier,  makes  up  the  chief  substance  of  the  spleen,  as  that 
terminates  in  cells. 

452.  The  Peritonaeum, 

is  a  serous,  (in  the  male)  entirely  closed  sack,  (in  the  female  open 
at  the  extremities  of  the  Fallopian  tubes,)  which  on  the  one  hand 
lines  the  abdominal  walls,  on  the  other  partially  invests  the  or- 
gans which  lie  within  them.  These  last  are  the  organs  of  diges- 
tion (below  the  diaphragm)  and  the  female  organs  of  generation. 
But  they  do  not  lie  within  the  cavity  of  the  sac,  but  in  folds  on 
the  external  surface  of  it.  Quite  unfolded,  the  sac  would  pre- 
sent the  appearance  of  a  bladder,  divided  into  a  larger  and  smaller 
(by  a  constriction),  but  which  are  connected  together  by  an 
opening  at  the  place  of  constriction,  and  of  which,  the  smaller 
(saccus  epiploicus,  because  it  forms  the  omentum,  epiploa)  is 
inverted  into  the  larger.  The  place  of  constriction  surrounds  a 
semicircular  (or  triangular)  space  (foramen  Winslowii),one  inch 
in  size,  which  is  bounded  before  by  the  gall-ducts,  behind  by  ven. 
cava  infer.,  below  by  duodenum,  above  by  the  neck  of  the  gall 
bladder,  and  is  situated  under  the  lobulus  Spigelii.  As  the  peri- 
tonaeum passes  upon  the  organs  contained  in  the  abdominal  cavity 
there  become  formed:  1.  Folds  (ligaments),  e.  g.,  such  as  lie 
between  two  different  viscera.  2.  Mesenteries  ;  these  are  inver- 
sions from  the  posterior  abdominal  walls  which  always  consist  of 
two  layers.  3.  Omenta  ;  these  are  prolongations  of  laminae  over 
the  organs. 

As  the  peritonaeum  forms  a  closed  sac,  the  description  of  it  may 
be  commenced  at  any  point. 

453.  A.  Peritonaeum  obdominale. 

The  walls  of  the  abdominal  cavity  are  lined  all  round  by  the 
peritonaeum  as  with  a  sac,  with  the  exception  of  those  places  on 
the  dorsal  wall,  at  which  inversions  take  place  into  the  interior  of 
this  sac,  for  the  purpose  of  surrounding  the  viscera  with  a  par- 
ticular envelope  (compare  Pleura),  and  thus  to  form  the  Peri- 
tonaeum viscerate.  The  internal  surface  of  this  parietal  layer 
looks  into  the  cavity  of  the  sac,  is  smooth  and  slippery  like  the 
visceral  layer,  which  is  turned  to  it.  The  external  surface  is 
rough,  loosely  attached  by  uniting  tissue  to  the  internal  surface  of 


THE  VISCERA.  223 

the  walls  of  the  abdominal  cavity.  It  is,  according  to  the  walls, 
divided  into : 

1.  Anterior  wall,  formed  by  the  abdominal  muscles.     It  covers  the  whole 
posterior  surface  of  the  anterior  and  lateral  abdominal  muscles,  separated 
from  it  by  fascite  rectce  and  transversal.     Of  it  four  folds  pass  off  from  the 
umbilicus. 

a.  Ligam.  suspensorium  hepatis,  the  so-called  suspensory  ligament  of  the 
liver,  upwards,  which  surrounds  the  lig.  teres  (the  obliterated  ven.  umbilicalis) 
at  the  sides  and  behind,  and  goes  to  the  liver. 

b.  Lig.  suspensorium  vesica  s.  Plica  urachi  passes  downwards  in  the  middle 
line  from  the  umbilicus,  on  the  obliterated  Urachus  to  the  superior  border  of 
the  urinary  bladder. 

c.  Plicte  pubfrwmbilicales,  two  lateral  folds  from  the  umbilicus  to  the  ligg. 
lateralia  vesicas. 

Between  these  folds  two  recesses  arise  behind  and  above  the  femoral  arch 
(Poupart's  Ligament)  on  either  side  of  the  middle  line,  the  external  of  which 
is  again  divided  by  the  obliquely  ascending  but  little  projecting  vasa  epigas.- 
trica.  On  each  side  we  therefore  observe : 

a.  Fovea  inguinalis  interna  between  symphysis  pubis  and  ven.  iliaca  (in  the 
crural  ring)  behind  lig.  Gimbernati. 

b.  Fovea  inguinalis  media  between  the  sides  of  the  lig.  later.  Vesicce  and  v. 
epigastr.  turned  towards  one  another,  above  and  behind  the  crural  ring  (im- 
portant in  crural  as  well  as  in  direct  inguinal  hernia). 

c.  Fovea  inguinalis  externa,  on  the  external  side  of  vasa  epigastrica  (im- 
portant in  oblique  inguinal  hernia). 

NOTE. — b.  and  c.  are  together  distinguished  as  fossa  inguinalis  externa. 

2.  The  inferior  or  pelvic  wall  descends  from  the  above  described  folds,  and 
the  posterior  surface  of  the  ossa  pubis  backwards,  into  the  small  pelvis  over 
the  superior  and  posterior  surfaces  of  the  urinary  bladder,  covers,  in  the 
female,  the  uterus  and  the  anterior  surface  of  the  rectum  ;  in  the  male,  imme- 
diately, the  last     Here  it  forms  between  bladder  and  uterus,  which,  together 
with  its  tubes,  ligg.  rotunda  and  both  the  ovaries,  it  receives  in  a  broad  fold,  a 
fossa  (excavatio  vesico-uterina),  the  two  broad  ligaments  (ligg.  lota),  and  alee 
vespertilionis ;  between  Uterus  and  Rectum  the  excavatio  recto^uterina,  between 
the  two  plica  Douglasii,  which  last,  in  the  male,  are   situated  between  the 
bladder  and  rectum.     Into  the  fossae  the  convolutions  of  the   small  intestines 
descend.     Hence  the  peritonaeum  ascends  to  the  dorsal  wall,  as: 

3.  The  posterior  wall,  situated  before  the  mm.  quadrati  lumborum,  the  Kid- 
ney.", Ureters,  Aorta  and  ven.  cava,  nn.  symphatici,  w.  azygos,  hemiazygos  and 
duct,  thoradcus,  and  forms,  hence,  the  inversions  or  reflections  for  the  viscera 
(periton.  viscerale),  the  access  to  which  is  concealed  by  uniting  tissue. 

4.  The  superior  wall  covers  the  inferior  surface  of  the  diaphragm,  passing 
over  behind  upon  the  Liver,  Stomach,  and  Spleen,  before  upon  the  anterior 
abdominal  walls. 

454.  B.  Peritonaeum  viscerate, 

the  intestinal  layer,  consists  of  two  large  and  several  smaller 
inversions  from  the  posterior  walls.  The  superior  larger  invests 
the  Liver,  Stomach,  Spleen,  Colon  transversum,  covers  the  an- 
terior surface  of  the  Duodenum  and  Pancreas,  and  contains  the 


224  SPECIAL  ANATOMY. 

Omenta;  the  inferior  larger  envelopes  the  Jejunum  and  Ileum, 
and  forms  the  mesentery  (mesentericum) ;  the  smaller  contain  : 
Csecum,  Colon  ascendens  and  descendens  and  rectum,  and  form 
their  mesenteries. 

455.  Route,  or  course,  of  the  Visceral  layer. 
[Reflections  of  the  Peritonssum  Viscerale.~] 

1.  From  the  inferior  part  of  the  pars  tendinea  of  the  diaphragm, 
the  Peritonaeum  passes  to  the  obtuse  posterior  border  of  the  liver, 
and  forms  Lig.  coronarium  hepatis,  the  right  and  left  extremity 
of  which  is  considered  as  Lig.  triangulare  dextrum  and  sinis- 
trum;  continues  to  the  superior  extremity  of  the  spleen,  and 
forms:  Lig.  phrenico-lienale;  lastly,  to  the  cardia  of  the  sto- 
mach, forming  a  right  and  left  lig.  phrenico-gastricum  on  the 
sides  of  the  cardia. 

456.  2.  From  these  places  the  Peritoneum  passes : 

a.  over  the  superior  surface  of  the   liver  to  the  inferior  surface  covering  it 
entirely,  with  the  exception  of  lobulus  Spigelii. 

b.  over  the  anterior  wall  of  the  Stomach  as  far  as  the  great  curvature. 

c.  over  the  whole  Spleen,  except  its  hilus;  forming  between  its  internal 
surface  and  the  fundus  of  the  Stomach  the  lig.  gastro-lienale,  the  posterior  layer 
of  which  passes  from  sacc.  epiploicus. 

457.  3.  The  Peritonaeum  afterwards  proceeds  : 

a.  from  the  right  portion  of  porta  hepatis  to  the  right  kidney  and  the  angle  of 
the  Colon  ascendens  (forms  lig.  hepatico-renale  s.  colicum  at  the  right  border  of 
for  am.  Winslowii). 

From  the  left  anterior  portion  of  the  Porta  (before  ven.  porta,  vasa  and  duct, 
hepatic,  downwards)  to  the  anterior  wall  of  the  duodenum,  forming  the  lig. 
hepatico-duodenale. 

From  the  fossa  ductus  venosi  towards  the  left,  to  the  smaller  curvature  of  the 
stomach,  forming  the  anterior  layer  of  the  small  omentum,  omentum  minus  s. 
lig.  hepatico-gastricum. 

This  attaches  itself  with  its  inferior  concave  border  to  the  small  curvature 
of  the  stomach,  with  its  superior  to: — 1.  The  porta  hepatis.  2.  The  oesophagus 
and  the  diaphragm ;  bounded  on  the  right  by  the  hepatic  vessels  and  gall  ducts 
(behind  them  foram.  Winslowii),  to  the  left  by  the  (Esophagus. 

b.  From  the  spleen  on  the  right  into  the  great  omentum,  on  the  left  to  the 
superior  angle  of  the  colon  descendens. 

c.  From  the  stomach  (over  the  anterior  surface  of  the  colon  transv.)  and 
behind  the  anterior  abdominal  walls,  before  the  small  intestines,  downwards 
into  the  pelvis.     Here  it  becomes  reflected  upon  itself,  and  ascends  to  the 
Pancreas  (Arnold.   According  to  others  it  goes  immediately  upon  the  superior 
surface  of  colon,  transv),  [covering  the  posterior  surface  of  the  transverse  arch 
of  the  colon,  and  forming  the  post,  layer  of  mesocolon  trans.],  and  thus  forms 
the  first  [anterior]  and  fourth  [posterior]  layer  of  the  great  omentum. 

Omentum  (s.  epiploon)  majus,  the  great  omentum,  reaches  in  adults  as  low 
as  the  femoral  arch,  is  transparent  and  thin,  in  fat  persons  much  beset  with 


THE  VISCERA.  225 

adipose  tissue,  particularly  around  the  vessels.  It  consists  of  four  layers,  the 
two  internal  of  which  are  formed  by  the  saccus  epiploicus.  Its  vessels  (from 
artt.  and  w.  gastro-cpiploica  dextra  and  sinistra)  descend  between  the  anterior 
layers  and  ascend  again  between  the  posterior,  anastomosing  with  those  of 
colon  transv.  Lymphatic  glands  on  the  curvature  of  the  stomach  and  the 
colon.  Nerves  from  plex.  Solaris,  along  with  the  arteries. 

Sacats  epiplaicus,  the  omental  sac,  is  formed  as  the  peritonaeum  passes 
through  the  for  am.  Winslowii  from  right  to  left,  above  the  hbulus  Spigelii  [to 
the  transv.  fissure  of  the  liver,  hence]  to  the  lesser  curvature  (as  posterior 
layer  of  small  omentum),  on  the  posterior  surface  of  the  stomach,  downwards 
behind  the  anterior  layer  of  the  great  omentum,  becomes  reflected  [back- 
wards] upon  itself  and  ascends,  before  the  posterior  layer,  covering  the  an- 
terior surface  of  the  Pancreas,  and  superior  third  of  Duodenum  [in  front  of 
the  anterior  surface  of  the  transv.  colon,  and  forming  the  ant  layer  of  trans, 
mesocolon],  and  inclining  to  the  right  it  passes  out  at  the  foramen  of  Win- 
slow,  [after  ascending  upon  the  crura  of  the  diaphragm,  being  reflected  upon 
and  covering  the  lobulus  Spigelii,  and  entering  the  transverse  fissure  of  the 
liver]. 

458.  4.  The  Peritonaeum  forming  the  fourth  layer  [posterior] 
of  the  great  omentum  was  traced  to  the  dorsal  wall  below  the 
Pancreas.     Hence  it  again  passes  downwards  and  forwards,  thus 
forming  the  two  layers  of  which  mesocolon  transv.  consists,  and 
which  lie  transversely  between  jejunum  and  ileum, — liver,  sto- 
mach, and  spleen. 

459.  5.  Turning  back  (as  inferior  [posterior]  layer  of  mesa- 
colon  trans.),  it  passes  again  downwards  before  the  second  and 
third  abdominal  vertebrae  [and  the  transverse  third  of  the  duo- 
denum~]  surrounding  the  numerous  convolutions  of  the  jejunum 
and  ileum,  and  again  turning  back  to  the  vertebral  column  (as  it 
forms  the  root  of  the  mesenterium),  it  thence  descends  to  the 
inferior  (pelvic)  wall  before  the  rectum,  &c. 

Mesenterium.  The  mesentery  consists  of  two  curly-folded  laminae  which 
lie  close  to  one  another, -pass  down,  vertically,  on  the  left  side  of  the  vertebral 
column  [obliquely  from  the  left  side  of  the  body  of  second  lumbar  vertebra 
to  the  right  sacro-iliac  synchondrosis],  receive  between  them  the  branches  of 
art.  and  ven.  mesenterica  superior,  Chyle  vessels  and  Lymphatic  glands  (gl. 
mesaraiccK),  and  at  the  concave  surface  of  the  small  intestines  separate  from 
one  another,  for  the  purpose  of  enclosing  these  organs. 

To  the  right,  left,  and  below,  we  find,  besides  this  large  inferior  inversion, 
several  smaller,  which  proceed  from  the  dorsal  wall  and  pass  into  the  parts 
described.  They  are  the  incomplete  mesenteries  for  the  colon  ascendens  and 
descendens  for  the  ccecum  and  sigmoid  flexure,  and  for  the  rectum  (mesorectum). 

460.  The  organs  of  Respiration,  Organa  respirationis, 

are  the  lungs,  the  thorax,  the  trachea,  the  larynx  and  pharynx, 
and  the  nasal  cavities. 
15 


226  SPECIAL  ANATOMY. 

461.  1.  The  Larynx,  larynx  s.  organon  vocis,  the  most 
superior  portion  of  the  trachea,  is  a  moveable  canal  formed  of 
seven  cartilages,  in  the  centre  of  the  anterior  superior  region  of 
the  neck,  under  the  os  hyoides,  before  the  inferior  part  of  the 
pharynx  (between  fourth  and  sixth  vert.). 

Shape  :  above,  broader  and  three-cornered  ;  below,  narrow  and 
cylindrical. 

Elements  :  cartilage,  ligaments,  muscles. 

a.  Cartilages  of  the  Larynx  :  Thyroid  and  Cricoid  are  true, 
the  rest,  fibre-cartilages. 


!•  Thyroid  cartilage,  cartilago  thyreoidea,  occupies  the  greatest  part 
of  the  anterior  and  lateral  walls,  and  consists  of  two  oblong  four-sided  plates, 
which  are  united  at  an  acute  angle,  in  the  middle  line,  and  the  surfaces  of 
which  are  directed  obliquely  backwards  and  outwards.  External  surface. 
In  the  male  the  angle  projects  more  strongly  forwards  (Adam's  apple)  than 
in  the  female,  and  before  puberty,  when  it  is  more  rounded.  At  the  pos- 
terior part  of  the  external  surface  of  each  lateral  plate  we  find  above,  a  tu- 
bercle, and  below,  a  larger;  between  the  two  we  perceive  a  linea  obliqua, 
before  which  m.  thyro-hyoideus  and  behind  which  mm.  constrictor  infer,  and 
sterno-thyreoid.  are  situated;  sometimes  a  foramen  for  Art.  laryngea  super. 
Internal  suri'ace  :  a.  At  the  angle  are  attached  the  vocal  cords  and  mm.  thyro- 
aryteenoidei.  b.  The  sides  project  out  over  the  cricoid  cartilage.  The  superior 
border  is  twisted,  in  the  centre  deeply  excised,  incisura  thyreoidea,  it  looks 
towards  the  hyoid  bone  and  terminates  at  the  sides  with  the  great  cornua. 
Here  is  attached  Membr.  hyo-thyreoid.  The  inferior  border,  shorter  than  the 
last,  inclines  towards  the  cricoid  cartilage,  serving  for  the  attachment  of  m. 
crico-thyreoid.,  in  the  centre  the  lig.  crico-thyreoid.  ;  is  bounded  externally  by  the 
lesser  cornua.  The  posterior  border,  slightly  twisted,  serves  for  the  attach- 
ment of  mm.  stylo-pharyngeus  and  pharyngo-staphylinus,  leans  on  the  vertebral 
column.  The  horns,  cornua,  are  oval  elongations  of  the  posterior  borders, 
directed  inwards  and  backwards.  The  larger  superior  are  in  connection 
with  the  hyoid  bone  by  ligaments,  the  less  inferior  with  the  cricoid  cartilage. 

2.  The  annular  cartilage,  cartil.  cricoidea,  thicker  and  more  solid  than  the 
other  cartilages  of  the  larynx,  is  circular,  narrow  before,  broad  behind  (one 
inch)  and  like  an  escutcheon,  four-cornered.     External  surface.     In  front  in 
the  centre  under  the  skin;  serves  laterally  for  the    attachment  of  mm.  crico- 
thyreoidei,  presents  an  articular  process  for  the  thyroid  cartilage;  behind,  in 
the  centre  a  projection  for  muscular  fibres  of  the  pharynx;  laterally,  a  depres- 
sion for  m.  crico-arytanoid.  posterior. 

The  internal  surface  is  covered  with  mucous  membrane.  The  inferior 
border  is  completely  circular,  connected  with  the  trachea  by  lig.  crico-tracheale. 
The  superior  border  is  irregular,  before  low,  with  two  articular  surfaces  (for 
the  arytcenoid  cartilages),  behind  (on  the  shield)  placed  higher.  The  shield 
forms  the  inferior  half  of  the  posterior  wall  of  the  larynx. 

3.  The  arytaenoid  cartilages,  cartilagines  arytcenoidce  s.  pyramidales  are  two 
moveable  cartilages,  standing,  close  to  one  another,  vertically,  upon  the  shield 
of  the  cricoid,and  forming  the  superior  part  of  the  posterior  wall  of  the  larynx. 
Below  broacf,  above  pointed,  the  anterior  surface  convex,  narrow,  grooved, 
with  the  superior  vocal  cord  ;  the  posterior  surface  concave  and  broad  (for  m. 


THE  VISCERA.  227 

aryteenoideus').  Basis,  articulated  with  the  cricoid.  cartilage,  with  the  posterior 
external  tubercle  (for  m.  crico-aryteenoid.  lateral,  and  posticus)  and  an  anterior 
(for  the  inferior  vocal  cord).  Apex  with  articular  surface  for  the  cornicula 
Santorini. 

4.  Cartilagg.  s.  cornicula  Santorini,  two  small  round  and  three-cornered  car- 
tilages upon  the  apex  of  the  arytaenoid.     Cart.   Wrisbergii,  small  cartilages 
sometimes  present  in  the  ligg.  ary-epiglottic.  between  epiglottis  and  cartt.  San- 
torini (in  some  animals  more  abundant). 

5.  The  epiglottis,  a  thin,  elastic,  and  yellow  fibro-cartilaginous  plate  behind 
the  root  of  the  tongue  and  before  the  entrance  to  the  Larynx,  is  three-oornered, 
heart-shaped,  and  curved  like  a  saddle ;  stands  upright,  directed  rather  back- 
wards ;  is  applied,  in  swallowing,  horizontally  over  the  entrance  to  the  larynx, 
and  is  broader  than  it.     The  anterior  surface  is  above  and  below  concave,  in 
the  centre  convex,  above  free  and  projecting  over  the  root  of  the  tongue,  it  lies 
below,  behind  the  root  of  the  tongue,  the  os  hyoides  and  the  thyroid  cartilage 
(with  the  strong  lig.  glosso-epiglotticum  medium,  containing  muscular  fibres,  the 
hyo-epiglotticum  and  gland,  epiglottica,  that  is,  fat,  between  epiglottis  and  thyroid 
cartilage").     The  posterior  surface  is  quite  free,  looks  into  the  larynx,  is  covered 
with  mucous  membrane  and   perforated  by  numerous  glandular   openings 
(gland,  epiglotticte).     In  the  centre  it  is  concave.     The  superior  border  is  broad 
(Basis)  slightly  sloping,  and  passes  with  rounded  angles  into  the  lateral  bor- 
ders, from  which  on  either  side  two  folds  (plica  aryteeno-epiglott.  and  pharyngo- 
epiglottica)  go  off,  and  to  which  the  reflector  is  attached.     The  apex  (pedicle) 
is  attached  to  the  superior  angle  of  the  thyroid  cartilage  (behind  pomum  JLdami) 
directly  over  the  vocal  cords,  the  lig.  thyreo-epiglotticum.  ,  • 

463.     b.  Connections  of  the  Larynx : 

1.  With  the  os  hyoides,  by  four  ligaments: 

a.  Lig.  thyreo-hyoideum  medium,  yellowish,  broad,  fills  the  space  between 
the  superior  border  of  the  thyroid  cartilage  and  the  os  hyoides  •  is  in  the 
(thick)  centre  covered  by  the  skin,  on  the  sides  -by  m.  thyreo-hyoid.,  lies 
before  the  Epiglottis  (separated  by  fat)  and  the  mucous  membrane. 

b.  Ligg.  thyreo-hyoidea  later  alia,  small  and  narrow,  between  the  greater 
(superior)  cornua  of  the  thyroid  cartilage  and  those  of  the  os  hyoides.     A 
Synovial  capsule  lies  between  the  posterior  surface  of  the  corp.  oss.  hyoid. 
and  the  superior  of  the  thyroid  cartilage. 

c.  Lig.  hyo-epiglotticum,  between  the  anterior  surface  of  the  epiglottis 
and  the  posterior  border  of  the  os  hyoides. 

2.  With  the  Trachea  by  lig.  crico-tracheale,  that  is,  a  small  fibrous  band 
which  strengthens  the  membrane  (on  the  anterior  surface)  between  the  cricoid 
cartilage  and  the  rings  of  the  Trachea. 

3.  Connection  of  the  Laryngeal  cartilages  with  one  another : 

a.  Lig.  crico-thyreoideum  medium  s.  conoideum,  yellow,  thick,  broad,  tri- 
angular, the  apex  at  the  inferior  border  of  the  thyroid,  the  basis  at  the 
superior  border  of  the  cricoid  cartilage  (before). 

b.  Ligg.  crico-thyreoidea  lateralia,  strong,  laterally  from  the  bend  of  the 
cricoid  [inner  lip  of  upper  border]  to  the  inferior  cornua  of  the  thyroid 
cartilage  [retreating  angle  of  Thyroid  cartilage],  horizontally  below  the 
inferior  vocal  cord. 

[Articulation  between  the  lesser  cornua  of  the  thyroid  cartilage  and  the 


228  SPECIAL  ANATOMY. 

surfaces  on  the  sides  of  the  Cricoid — surfaces  plane.  Ligament,  capsular 
with  shining,  parallel  fibres — -synovial  capsule.  The  crico-thyroid  articu- 
lations are  all  Arthodial.  T  HASPS/) 

c.  Ligg,  crico-arytcenoidea  unite  the  arytanoid  cartilages  with  the  plate  of 
.the  cricoid,  at  the  posterior  internal  surface  ;  strong  but  loose.  [Synovial 
capsule.]  The  aryt<enoid  cartilages  are  moveable  in  all  directions,  but 
especially  outwards  and  inwards. 

.  d.  Ligg.  aryt&no-epiglotticum,  inside  the  folds  of  mucous  membrane 
from  the  anterior  surface  of  the  arytanoid  cartilages  to  the  borders  of  the 
epiglottis. 

4,  Vocal  cords,  ligg.  vocalia  s.  glottidis,  s.  thyreo-aryttenoidea,  are  four  liga- 
ments which  extend  between  the  angle  of  the  thyroid  (on  the  posterior  sur- 
face) and  the  anterior  surface  of  the  'arytanoid  cartilages,  passing  from  before 
to  behind  through  the  midst  of  the  cavity  of  the  larynx.  There  are,  right  and 
left,  a  superior  and  an  inferior.  The  triangular  fissure  between  those  on  the 
right  and  those  on  the  left  side  is  called  the-  glottis  s.  rima  glottidis,  is  before 
narrow,  behind  roundish,  at  that  part  formed  by  cartil.  cricoid.  and  cartt.  arytte- 
noid.j  and  is  not  capable  of  being  completely  closed  (Mayer). 

a.  Ligg.  vocalia  inferiora,  are  thick  roundish  cords  attached  before  to  the 
angle  of  the  thyroid,  behind  to  the  anterior  tubercle  of  the  arytanoid  car- 
tilages ;  covered  externally  by  m.  thyro-arytanoideus,  internally  by  closely- 
applied  mucous  membrane,  they  meet  below  at  the  ligg.  crico-thyreoid. 
lateralia. 

b.  Ligg.  vocalia  superiora,  less  strong  than  the  last,  above  them  in  the 
middle  of  the  larynx,  under  the  Epiglottis,  not  quite  horizontal.     Below 
them  the  mucous  membrane  forms  a  sac,  ventriculus  Myrgagni;  above 
they  meet  in  lig.  arytano-epiglotticum. 

464.  C.  The  muscles  of  the  Larynx.  The  whole  larynx  is 
moveable :  Mm.  sterno-,  omo-,  thyreo-hyoidei,  sterno-thyreoidei, 
&c.  (see  before);  the  separate  cartilages,  are  moved  by  the  fol- 
lowing muscles : 

1.  Crico-thyreoidd,  two  short,  thick,  triangular  muscles  on  the  anterior  sur- 
face of  the  larynx,  behind  m.  sterno-thyreoid  and  thyroid  gland,  in  contact  below 
with  the  last,  above  m.  crico-aryteenoid.  later ;  the  internal  borders  separated  by 
a  quadrangular  space.     Or. :  the  anterior  surface  of  the  cricoid  cartilage.    Ins. : 
the  inferior  border  and  internal  surface,  and  the  anterior  border  of  the  inferior 
Cornua  of  the  thyroid  cartilage.     Use :  to  approximate  the  cricoid  and  thyroid 
cartilages,  elongating  the  glottis  and  stretching  the  vocal  cords. 

2.  Crico-arytcenoidei  postid,  triangular,  on  the  posterior  surface  of  the  cricoid, 
covered  before  by  this,  behind  by  the  mucous  membrane  of  the  Pharynx.    Or. : 
from  the  posterior  surface  of  the  cricoid  cartil.     Ins. :  external  angle  of  basis 
cartil.  arytten.     Use :  to  separate,  the  two  vocal  cords  of  either  side  from  one 
another,  widening  the  posterior  part  of  the  rima  glottidis. 

3.  Crico-aryteenoidei   laterales,  two  flat,  rhomboidal-shaped   muscles.     Situ- 
ation :  on  the  posterior  wall  of  the  Larynx  (internal  surface),  oblique  upwards 
and  backwards ;  closely  connected  internally   with   thyreo-arytten.     Or. :  the 
lateral  part  of  the  superior  border  of  the  cricoid  cartilage.     Ins. :  external.angle 
of  the  aryt&noid  cartilages.     Use. :  to  draw  the  external  angles  of  the  arytanoid 
cartilages  forwards;  the  anterior  angles  with  the  vocal  cords  pass  inwards, 
and  thus  contract  the  rima  glottidis. 


THE  VISCERA.  229 

4.  Thyreo-arytcenoidei,  two  thin,  longish  processes  of  the  last  muscle.     Situ- 
ation :  between  thyroid  cartilage  and  mucous  membrane  of  the  internal  surface 
of  the  Larynx,  chiefly  in  the  fold  of  the  vocal  cords.     Or. :    the  angle  (in- 
ferior two  thirds)  of  the  thyroid  cartilage.     Ins. :  the  anterior  angle  of.  the  ex- 
ternal border  of  the  arytcenoid  cartilages.     Use:  to  draw  the  cartil.  arytcenoid. 
forwards,  and  shorten  the  rima  glottidis ;  extending  at  the  same  time  the  vocal 
cords. 

5.  Jlrytcenoideus,  short,  thick,  rhomboidal,  lying  in  the  concave  posterior  sur- 
faces of  the  arytcenoid  cartilages,  and  in  the  space  which  divides  them ;  con- 
sists of  a  deep  transverse  layer,  that  is,  aryt.  transversus,  and  two  crossing  each 
other  obliquely,  arytcenoidei  obliqui.     The  inferior  border  touches  the  cricoid 
cartilage:  upon  the  superior  lie  glands,  and  a  fold  of  mucous  membrane 
which  separates  the  introitus  laryng.  from  the  Pharynx.     Points  of  attach- 
ment: the  external  angle  and  the  posterior  concave  surface  of  cartt.   ary- 
tcenoidece.     Use :  to  approximate  the  aryt&noid  cartilages,  and  thus  contract  the 
posterior  part  of  the  rima  glottidis. 

6.  Reflector  epiglottidis  (Theile)  ;  in  the  fold  of  mucous  membrane  from  the 
lateral  borders  of  the  epiglottis  to  the  cartitt.  arytcenoid.  and  Santorini  of  either 
side.     Or.:  from  three  places.  1.  Posterior  portion  from  the  external  angle  of 
cartil.  arytcenoid.  of  the  other  side,  crosses  obliquely.     2.  Central  portion,  from 
the  attachment  of  the  superior  vocal  cords  to  the  arytcenoid  cartilages.     3. 
Anterior  portion,  from  the  internal  surface  of  the  thyroid  cart.     Ins. :  lateral 
border  of  the  epiglottis.     Use :  bends  the  epiglottis  backwards,  closing  (and 
contracting)  the  entrance  to  the  larynx. 

c.  The  mucous  membrane  of  the  larynx,  a  continuation  of  that  of  the 
mouth  and  nose,  passes  from  the  root  of  the  tongue  upon  the  anterior  surface 
of  the  Epiglottis,  as  it  forms  three  folds  (ligg.  glosso-epiglottica),  then  covers  the 
posterior  surface  and  passes  from  its  borders  upon  the  cartil.  arytcenoid.,  and 
from  these  upon  the  posterior  surface  of  the  larynx  (where  this  forms  a  por- 
tion of  the  anterior  wall  of  the  Pharynx).     At  the  lateral  parts  of  the  en- 
trance to  the  larynx,  above  the  rima  glottidis.  the  mucous  membrane  forms  two 
folds  {ligg.  ary-epiglottica),  covers  the  superior  vocal  cords,  is  loosely  suspended 
in  the  pocket-like  hollows  which  the  ventriculi  Morgagni  form,  but  firmly  and 
thin  to  the  inferior  vocal  cords,  from  which  it  passes  over  upon  the  internal 
surface  of  the  cricoid  cartilage,  the  memb.  crico-thyreoid  and  the  Trachea. 

The  mucous  membrane  is  very  thin,  pale  red,  very  sensitive  (particularly 
over  the  rima  glottidis),  and  contains  in  the  ligg.  ary-epiglottica  much  (serous) 
uniting  tissue. 

d.  Glands:     1.  Gland,  epigbtticce,  small,  numerous,  under  the  mucous  mem- 
brane, on  the  posterior  surface  of  the  larynx;  they  open  towards  the  sides  of 
the  larynx. 

2.  Gl.  arytffnoidea  (Morgagni"),  lie  in  the  Plica  (ligam.')  ary-epiglottica  in  the 
shape  of  letter  L,  opening  into  the  larynx.  The  vertical  portion  lies  on 
the  anterior  surface  of  the  aryfcenoid  cartilages,  the  horizontal  on  the  superior 
vocal  cord. 

e.  Vessels:  JLrtt.  and   Ten.  laryngea  super,  and  infer,  (from  thyreoid  super. 
and  infer.').     Lymphatics  pass  into  the  glands  above  the  hyoid  bone  (in  the 
neck). 

f.  Nerves:  N.  laryngeus  superior  and  laryng.  inferior  (s.  recurrent)  from  n. 
vagus. 


230  SPECIAL  ANATOMY. 

465.       The  Thyroid  Gland,  Glandula  thyreoidea, 

a  blood  gland  on  the  anterior  part  of  the  neck,  between  the  in- 
ferior half  of  the  thyroid  cartilage  and  the  superior  rings  of  the 
trachea,  lying  in  the  shape  of  a  crescent  with  the  horns  directed 
upwards,  varying  in  circumference  (in  the  female  larger  than  in 
the  male),  and  weight  one  ounce  or  more,  heavy;  of  a  bluish,  in 
the  embryo  more  of  a  bright  red,  colour;  consists  of  two  lobes, 
lobi,  cornua,  and  a  central,  inferior,  and  flat  portion,  isthmus, 
from  which  frequently  a  third  lobe,  cornu  medium,  ascends  as 
far  as  incisura  thyreoidea.  But  the  isthmus  is  also,  frequently, 
so  small,  that  it  appears  to  be  entirely  wanting ;  or  it  reaches 
down  as  far  as  the  sternum.  The  isthmus  is  before  convex,  and 
separated  from  the  skin  by  mm.  sterno-hyoid.  and  thyroideus 
and  fascia  colli;  behind  concave,  and  lying  before  the  rings  of 
the  trachea.  The  lateral  lobes  are  before  convex  and  covered 
by  the  m.  sterno-thyreoid;  internally  concave,  and  surrounding 
the  inferior  part  of  the  thyroid  cartilage,  the  lateral  portion  of 
the  trachea,  the  inferior  of  the  pharynx,  and  the  superior  of  the 
(Esophagus;  they  are  in  relation  with,  behind,  the  vertebral  co- 
lumn (separated  from  it  by  Art.  carotis  commun.,  V.  jugular 
int.  n.  vagus  and  sympathicus).  The  apex  of  the  cornu  lies  on 
the  outer  side  of  Art.  carotis,  on  the  outer  and  posterior  of  the 
thyroid  cartilage,  and  sometimes  reaches  as  far  as  its  superior 
border.  The  inferior  extremity,  thick  and  round,  lies  before  the 
fifth  and  seventh  tracheal  rings,  between  the  trachea  and  the 
carotis  commun.;  here  the  Art.  thyreoid.  infer,  enters  the  in- 
ferior convex  border  of  the  gland ;  at  the  superior  concave  bor- 
der the  art.  thyreoid.  superior  occurs. 

The  Parenchyma  of  the  Thyroid  gland  consists  of  a  spongy  uniting  tissue, 
the  cells  of  which  are  connected  by  openings  with  each  other,  without  pos- 
sessing any  excretory  duct;  perforated  by  many  vessels  it  contains  a  yellowish 
white  serum,  the  destination  of  which  is  not  known.  Externally  the  thyroid 
gland  is  invested  by  a  dense  uniting  tissue  which  is  strengthened  by  fasc.  cer~ 
vicalis,  M.  thyroideus  (see  before). 

Vessels:  Jirtt.  thyreoid.  super,  (from  A.  carotis)  and  inferior  (from  subdavia), 
Vv.  thyreoid  sup.  and  med.  (in  V.  jugular  intern."),  inferior  (in  V.  anonyma~). 

Nerves:  N.  laryngeus  super,  and  infer,  (from  N.  Vagus),  and  branches  of 
gang/,  cervic.  med.  or  infimum  of  N.  sympathicus. 

466.       2.  The  Windpipe,  Trachea,  arteria  aspera, 

is  a  moveable  tube  composed  of  cartilages  and  membranes,  four 
or  five  inches  long,  which,  close  under  the  cricoid  cartilage,  ex- 
tends from  the  fifth  cervical  as  low  as  the  third  dorsal  vertebra, 
in  which  region  it  divides  into  its  two  branches,  bronchi.  In 


THE  VISCERA..  231 

front  and  at  the  sides  cylindrical,  it  is  formed  of  from  seventeen 
to  twenty  cartilages  placed  one  above  the  other,  and  of  the  shape 
of  the  letter  O ;  behind,  flat  and  membranous. 

Cervical  portion.  1.  Before  and  above,  covered  by  isthmus 
'.  thyreoid.,  mm.  sterno-thyreoidei  and  fasc.  cervicalis,  below 
y  much  uniting  tissue  (Art.  thyreoidea),  and  a  little  by  Art. 
anonyma.  2.  At  the  sides:  Gl.  thyreoidea,  A.  carotis  comm., 
n.  vagus,  lymphatic  glands.  3.  On  the  posterior  surface :  oeso- 
phagus (which  projects  rather  to  the  left),  n.  recurrens  dexter 
and  sinister  (which  passes  towards  the  left  side). 

Dorsal  portion,  in  the  mediastinum  posticum.  Before  it  lie, 
from  above  downwards:  Sternum  and  m.  sterno-thyreoid,  V. 
subclavia  sinist.  and  truncus  anonymus,  the  posterior  portion  of 
Jlrcus  AortsR  and  Art.  pulmonalis  (bifurcation) ;  behind  it:  (Eso- 
phagus; on  the  sides:  Pleura,  Nn.  vagus and  recurrens  (superior 
part) ;  a  quantity  of  uniting  tissue  and  lymphatic  glands. 

The  Bronchi  are  the  two  branches  of  the  trachea,  into  which  it  divides 
before  the  third  dorsal  vertebra.  The  obtuse  angle  of  division  (bifurcation) 
is  filled  up  by  a  triangular  ligament  and  the  blackish  bronchial  glands.  The 
bronchus  dexter,  one  inch  long,  about  eight  lines  thick,  consists  of  five  to  six 
O  shaped  cartilaginous  rings,  divides  into  three  branches  with  which  it  enters 
into  the  right  lung,  and  lies  close  under  the  bend  of  V.  azygos,  behind  V.  cava 
superior  and  Art.  pulmonalis  dextra.  Bronchus  sinister, — two  inches  long,  about 
five  lines  thick,  consists  of  from  ten  to  twelve  O  shaped  cartilages,  divides 
into  two  branches  fcr  the  two  lobes  of  the  left  lung,  lies  under  the  arcus 
Aortas  and  obliquely  before  the  oesophagus,  behind  Art.  pulmonal.  sinistra  and 
before  aorta  descendens.  Between  each  bronchus  and  Artt.  pulmonaks  we  find 
the  Vc.  pulmonales.  The  branches  of  the  bronchi  again  ramify  and  always 
dichotomously  (bronchia)  until  at  last  they  terminate  in  the  pulmonary  vesi- 
cles. Vessels :  Artt.  bronchus  come  from  the  Aorta  ;  Vv.  bronch.  enter  the  V. 
azygos  (upon  the  right  side),  the  v.  inter  cost,  (upon  the  left). 

Structure.  1.  The  cartilaginous  rings  are  placed  at  tolerably  equal  inter- 
vals, horizontally  above  one  another,  the  interspaces  filled  up  with  fibrous 
rings.  Flexible  and  elastic  in  the  young,  they  frequently  ossify  as  age  ad- 
vances. Of  unequal  vertical  diameter  (l£  to  2£  lines)-,  several  of  them  fre- 
quently unite  together.  The  vertical  diameter  of  the  first  is  the  greatest. 
The  last,  the  longest,  is  turned  downwards,  has  behind  an  acute  angle  where 
the  first  Bronchial  rings  pjiss  off.  2.  The  fibrous  membrane  (perichondrium) 
commences  at  the  inferior  border  of  the  cartilages  to  which  it  passes  as  lip. 
crico-tracheale,  covers  both  surfaces  of  the  cartilages,  fills  the  interspaces,  and 
assists  (with  the  other  membranes)  to  form  the  posterior  flat  wall  of  the 
trachea  and  bronchi,  which  is  attached  by  uniting  tissue  to  the  oesophagus.  3. 
Transverse,  smooth  muscular  fasciculi,  between  the  posterior  extremities  of 
the  cartilages  approximate  these  to  one  another.  4.  Yellow,  elastic  bundles 
of  fibres,  pass  parallel  to  the  long  axis  on  the  internal  surface  of  the  muscular 
coat  5.  The  mucous  membrane  is  thin,  paler  than  in  the  larynx,  firmly 
attached  (without  folds),  and  perforated  by  numerous  openings,  which  are  the 
openings  of  small,  flat,  oval  glanduL  tracheales,  which  are  situated  between  the 
mucous  and  muscular  coats. 


232  SPECIAL  ANATOMY. 

Vessels  of  the  Trachea:  1.  Jirtt.  tracheales  (from  thyreoid.  infer.)  inferiores 
(from  the  Aorta],  2.  The  veins  of  the  spaces  between  the  cartilages  open 
into  the  great  trunks  along  the  trachea  (on  the  internal  surface),  and  these 
into  the  Vv.  thyreoidea  infer.,  mammar.,  and  azygos.  3.  The  Lymphatics,  very 
numerous,  pass  into  the  great  lymphatic  glands  at  the  bifurcation. 

Nerves :  Nh.  tracheal.  superior,  (from  ram.  recurrens  Vagi]  ; — inferiores  (of 
the  trunk  of  plexus  pulmonalis  of  N.  Vagus). 

467.  3.  The  Lungs,  Pulmones, 

are  two  soft  bodies,  between  which  lies  the  heart,  and  each  of 
which  fills  up  the  lateral  half  of  the  cavity  of  the  thorax ;  of.  an 
irregular,  conical  shape,  internally  deeply  excavated,  with  the 
base  directed  downwards.  Colour:  in  the  adult  and  aged,  greyish 
blue,  traversed  by  dark  blue  vessels  and  bluish  black  spots,  which 
form  polygons,  on  which  account  the  surface  appears  marbled ; 
the  posterior  surface  (generally)  a  reddish  brown.  As  age  ad- 
vances, the  black  spots  which  lie  in  the  interposed  uniting  tissue, 
increase.  Weight:  In  the  foetus  the  lungs,  in  relation  to  the  body, 
are  as  1  :  60 ;  in  the  adult,  1  :  30.  Spec.  gray,  before  birth  and 
respiration  :  heavier  than  water ;  afterwards :  lighter  than  water. 
In  the  male,  the  lungs  are  heavier  (3£  pounds)  than  in  the  female 
(2|  pounds). 

Each  lung  is  invested  by  a  serous  membrane  (pleura),  and 
presents  :  1.  An  external,  convex  surface,  which  is  separated  from 
the  ribs  by  the  pleura  only,  and  by  a  deep  fissure,  incisura  inter- 
lobularis,  into  two  and  three  lobes  (lobi).  The  fissure  commences 
behind  and  above  below  the  apex,  and  reaches  downwards  and 
forwards  to  the  anterior  part  of  the  basis  of  the  lung.  On  the 
right  lung,  a  second  fissure  passes  upwards  and  forwards  before 
the  termination  of  the  last. 

2.  The  internal  surface,  above  flat,  below  excavated,  presents, 
in  the  centre  between  basis  and  apex,  and  rather  towards  the  pos- 
terior border,  a  surface  one  inch  high,  a  depression  half  an  inch 
broad  (the  root,  radix,  hilus),  at  which  bronchi,  arteries,  and 
nerves  enter,  and  veins  and  lymphatics  pass  out.    Behind  the  root 
the  internal  surface  looks  towards  the  vertebral  column ;  and,  on 
the  left  side,  towards  aorta  descendens  [the  lung  has  a  correspond- 
ing groove],  and  the  superior  part  of  Ductus  thoracicus,  on  the 
right  side,  towards  V.  azygos,  oesophagus,  and  the  inferior  part 
of  the  duct,  thoracicus;  before  the  root  on  the  left  lung,  the  left 
border,  the  apex  of  the  heart  and  Aorta  descendens;  on  the  right 
lung,  the  right  auricle  of  the  heart  and  V.  cava  superior. 

3.  The  anterior  border  is  thin,  and  presents  two  notches :  an  in- 
ferior (to  the  left  for  the  apex,  to  the  right  for  the  auricle  of  the 
heart) ;  and  a  superior  (to  the  left  for  Art.  subclavia,  the  right  for 
V.  cava  superior). 


THE  VISCERA.  233 

4.  The  posterior  border  is  broad,  obtuse,  and  lies  at  the  side  of 
the  vertical  column. 

5.  Basis  is  hollowed  out,  rests  upon  the  (convex)  diaphragm  ; 
its  posterior  border  reaches  deeper  downwards  than  the  anterior, 
almost  as  far  as  the  inferior  surface  of  the  liver. 

6.  Apex,  is  round,  and  projects  (one  inch)  upwards  above  the 
first  rib. 

The  left  lung  is  narrower  and  lighter,  but  longer  than  the  right 
(on  account  of  the  heart) ;  has  one  fissure  (incisura)  and  two 
lobes,  a  larger  superior,  a  smaller  inferior. 

The  right  lung  is  less  (in  the  vertical  diameter,  on  account  of 
the  liver),  but  broader;  has  two  indsurse  and  three  lobes  ;  the 
larger  superior,  the  smaller  inferior,  and  the  smallest  central  lobe. 

Parenchyma  of  the  lungs.  The  spongy  and  soft  tissue  of  the 
lung  is  very  strong,  elastic,  crepitates  under  the  pressure  of  the 
finger  when  respiration  has  been  once  performed,  and  consists  of 
the  following  parts : 

a.  Aeriferous   vessels,   vasa   aerofera.      After   the   Bronchi   have    divided 
many  times  (always  at  an  acute  angle),  the  small  branches  (bronchia}  lose 
the  regular  structure  of  the  larger  5  the  cartilages  on  the  anterior  wall  are  no 
longer  in  the  shape  of  the  letter  C,  but  irregular,  and  are  finally  entirely 
lost,  like  the  muscular  fibres,  until  at  last  vesicles  with  roundish  corners,  and 
terminating  in  a  cul-cle-sac,  vesiculte  pulmonaks  s.  cellulte  aereee  (of  one-sixth  to 
one-sixteenth  of  a  line),  remain,  which  consist  of  mucous  membrane  and 
thin  longitudinal  fasciculi  of  uniting  tissue.     The  pulmonary  vesicles  open 
into  a  common  canal,  to  which  they  hang  like  berries  upon  their  stalks 
(as  in  glands),  and    form  a  pulmonary  lobule   (lobulns).     The    pulmonary 
lobules  are  again  associated  in  one  great  canal  into  a  lobe  (lobus),  and  are, 
like  these,  isolated  from  one  another  by  the  serous  membrane  which  forms 
their  envelope. 

b.  Pulmonary  vessels,  vasa  pulmonalia. — 1.  Art.  pulmonalis  ramifies  with 
the  branches  of  the  bronchi,  and  surrounds  the  lobuli  with  a  large  circle  of 
capillary  vessels,  and  the  pulmonary  vesicles  with  a  smaller  and  more  deli- 
cate rete  (of  0'02  to  O'OG  of  a  line  diam.),  between  the  meshes  of  which  the 
vesicles  lie,  so  mat  through  the  thin  wall  of  both  the  inspired  air  (in  the 
vesicles)  comes  into  immediate  relation  with  the  venous  blood  (in  the  arte- 
ries) and  changes  it  into  bright  red,  arterial  blood,  which  through :  2.   Vv. 
pulmonaks  flows  back  again  into  the  heart.     Two  pulmonary  venous  branches 
(to  each  branch  of  the  pulmonary  artery)  arise  from  the  capillary  rete  of  the 
art.  pulmonal.  and  bronchialis. 

c.  Bronchial  vessels,  vasa  bronchialia. — 1.  Artt.  bronchioles  do  not  pass  to 
the  pulmonary  vesicles,  but  to  the  walls  of  the  bronchia,  art.  pulmonalis,  to  the 
Bronchial  glands,  to  the  uniting  tissue  between  the  lobules  and  the  pleura; 
they  serve  for  the  nourishment  of.  and  for  secretion  in,  these  parts ;  they  arise 
from  the  Aorta  thoracica  and  mammaria  interna,  and  frequently  anastomose 
with  A.  pulmonalis;  passing  into  the  commencements  of  w.  bronchioles,  but 
also  the  m.  pulmonaks. — 2.   Vv.  bronchioles  open  inside  the  lung  into  the  Vv. 
pulmonaks;  outside,  upon  the  right  side  into  ven.  azygos,  upon  the  left  side 
into  Ven.  intercostal,  superior.. 


234  SPECIAL  ANATOMY. 

d.  The  lymphatics,  superficial,  are  very  numerous ;  a  trunk  also  passes  out 
from  the  interior  of  the  lung  at  the  root ;  however,  in  their  interior  the  re'te  is 
not  yet  sufficiently  demonstrated ;  they  pass  into  the  gl.  bronchiales  and  tra- 
cheales,  which  become  black  between  the  tenth  and  twentieth  year. 

e.  Nerves :  branches  of  N.  vagus  and  (a  few)  of  N.  sympathicus  form  a  plexus 
pulmonalis  anterior,  which  spread  upon  the  bronchia  in  the  interior,  and  a  pos- 
terior which  go  to  the  larger  branches  of  the  Bronchi. 

f.  Interlobular  uniting  tissue,  consists  of  fine  fibres  which  surround  the 
vesicles  in  thin,  the  lobules  in  rather  thicker  lamina?,  containing  no  fat,  but 
with  tune  on  the  surface  of  the  lung  the  colouring  matter  which  produces  the 
black  spotted  appearance. 

Function  of  the  Lungs.  The  change  of  the  venous  into  arterial 
blood,  effected  by  the  inspiration  of  atmospherical  air,  and  excre- 
tion of  carbonic  acid,  resulting  from  expiration. 

468.  4.  The  Pleurse,  Sacci  pleurse, 

are  two  closed  serous  sacs,  one  of  which  covers  each  lateral  half 
of  the  thoracic  cavity,  and  then  the  lung.     We  distinguish: 

a.  Pleura  costalis,  that  is,  the  part  which  loosely  attached  to 
the  internal  surfaces  of  the  ribs  and  mm.  inter co stales,  extends 
from  the  border  of  the  sternum  to  the  sides  of  the  dorsal  vertebra, 
covering  before  the  vasa  mammaria,  behind  (before  the  heads  of 
the  ribs)  the  ganglia  n.  sympathici,  and  projecting  above  over 
the  first  rib  and  the  apex  of  the  lung. 

b.  Pleura  phrenica  passes  off  below  from  the  pi.  costalis, 
firmly  attached  to  the  superior  surface  of  the  diaphragm,  and  by 
a  triangular  fold,  Kg.  pulmonis,  with  the  posterior  border  of  the 
inferior  lobes  of  the  lungs,  and  with  the  pulmonary  veins. 

c.  Mediastinum,  is  that  part  of  the  Pleura  which  is  reflected 
before  from  the  borders  of  the  Sternum,  behind  from  the  sides  of 
the  dorsal  vertebra  upon  the  roots  of  the  lungs,  whereby  a  medi- 
astinum anticum  and  posticum  arises.  The  anterior  mediastinum 
is   different  on   both  sides;   the  right,  for  instance,  commences 
above  from  the  right  border  of  the  manubrium;  below  from  the 
centre,  indeed  from  the  left  border  of  corpus  sterni;  the  left,  from 
the  left  border  of  manubrium  sterni,  and  below  from  the  external 
extremity  of  the  sixth  and  seventh  rib  cartilages.     Between  the 
two  anterior  and  the  two  posterior  mediastina  an  X  shaped  space 
remains,  cavum  mediastini,  which  is  divided  by  the  heart  (or,  as 
the  French  describe  it  with  greater  accuracy,  by  the  roots  of  the 
lungs),  into  an  anterior  and  posterior. 

1.  Cavum  mediastini  antici,  is  bounded  before  by  the  Sternum  and  the  left 
rib  cartilages,  laterally  by  the  two  anterior  mediastini,  behind  by  pericar> 
dium,  the  great  vessels,  and  above  by  the  trachea.  Above  narrow  and 
vertical,  below  sloping  and  directed  towards  the  left ;  it  contains : 

the  Thymus  gland  [or  its  remains],  nn.  phrenici,  glandul.  mediastini 


THE  VISCERA.  235 

antic.,  adipose  and  uniting  tissue  which  is  connected  above  with  that 
on  the  anterior  part  of  the  neck,  below  with  that  of  the  anterior  ab- 
dominal parietes. 

2.  Cavum  mediastini  postici,  more  spacious  than  the  anterior,  not  oblique, 
bounded  before  by  the  pericardium  and  roots  of  the  lungs,  behind  by 
the  bodies  of  the  dorsal  vertebra,  laterally  by  the  posterior  mediastini ; 
contains: 

aorta  thoracica,  oesophagus,  nn.  vagi,  duct,  thoracicus,  w.  azygos  and  henri- 
azygos,  uniting  tissue,  gland,  mediast.  post. 

d.  Pleura  pulmonalis  is  formed  by  the  mediastini  of  the  roots 
of  the  lungs,  the  vessels  passing  in  and  out  of  which  they  en- 
velope, being  reflected  upon  the  internal  surface  of  each  lung, 
and  firmly  attached  covering  the  external  surface ;  also  entering 
between  the  lobes,  and  forming  ligg.  interlobularia.  Thus  also 
there  remains  between  Pleura  pulmonalis  and  the  other  portions 
of  the  Pleura  a  closed  cavity,  the  smooth  moist  walls  of  which 
frequently  secrete  a  serous  fluid,  lie  close  together,  and  (frequently) 
are  in  places  united  with  each  other. 

Vessels  are  doubtful.  Branches  of  the  neighbouring  intercostales,  mammarus 
internee,  phrenicce  superr.,  &c.,  form  a  capillary  network  which  manifests  itself 
in  inflammation,  but  only  on  the  external  surface  of  the  Pleura. — Lymphatics : 
numerous,  open  into  plex.  mammar.  and  intercostalis. — Nerves :  not  yet 
found  out. 

469.  Thymus  Gland,  Glandula  thymus, 

the  sweetbread,  a  so-called  blood  gland,  grows  from  the  third 
month  of  foetal  life  until  the  termination  of  the  first  year  after 
birth,  then  by  degrees  diminishes  from  below  upwards,  and  en- 
tirely disappears  with  the  twelfth  year.  In  its  complete  perfec- 
tion it  consists  of  two  lateral  lobes  (only  associated  by  uniting 
tissue)  so  that  properly  we  must  admit  two  flat,  three-cornered 
thymus  glands  above  and  below  pointed,  which  are  situated  in 
the  superior  part  of  cavum  mediastini  antici,  before  the  junction 
of  the  vv.  anonymse,  behind  the  manubrium  sterni,  reach  as  far 
upwards  as  the  thyroid  gland,  and  contain  a  large  cavity  filled 
with  white  fluid  (F.  W.  Becker),  with  which  the  cavities  of  the 
lobules,  the  size  of  a  pea,  are  connected.  The  cavity  is  not 
bounded  by  a  proper  membrane.  Astley  Cooper  maintained  that 
a  large  lymphatic  vessel,  which  opens  into  the  vena  anonyma, 
served  as  an  excretory  duct. 

The  Parenchyma  is,  like  that  of  the  thyroid  gland,  pale  red.  The  lateral 
lobes  divide  into  three  or  four  larger,  and  these  again  into  a  number  of 
smaller  lobuli,  which  are  associated  together  by  uniting  tissue,  in  which  fat 
cells  are  present.  The  corpuscles  which  exist  in  the  lobules,  resemble  the 
nuclei  of  the  blood  discs  and  the  globules  of  demolished  nerve  substance 
(Ehrenberg). 

Vessels:  Artt.  thymica   come    from  art.  mammaria   interna  and   subclavia, 


236  SPECIAL  ANATOMY. 

sometimes  from  thyreoidaa,  carotis,  or  .arcus  aortce.     Veins  open  into:  v.  cava 
sup.,  subclavia,  thyreoid.,  mammaria  internet,. 
Function  (see  Blood  glands). 

The  Urinary  Organs,  Organa  uropoetica. 
470.  1.  The  kidneys,  renes,  vf<j>pot,  are  two  dense  glands  {gl. 
tubulosse)  in  the  reg.  lumbalis,  close  to  the  sides  of  the  first  to 
third  lumbar  vertebra,  outside  the  peritoneum,  surrounded  by 
uniting  tissue  with  abundance  of  fat;  generally  .smooth  on  the 
surface,  sometimes  (as  in  the  foetus  and  several  animals)  grooved. 
The  right  kidney  lies  rather  lower  than  the  left  (on  account  of 
the  liver).  Length:  three  and  a  half  to  four  inches.  Breadth: 
two  inches.  Thickness :  one  inch.  Weight :  two  to  four  ounces. 
Colour:  reddish  brown.  Figure:  bean-shaped;  the  fissure 
£Hilus]  directed  inwards  towards  the  vertebral  column.  Posi- 
tion: upright. 

a.  The  anterior  surface  looks  rather  outwards,  is  convex  ;   the 
left  covered  by  Colon  descendens,  above  by  the  Spleen  and  caudu 
pancreatis;  the  right  by  colon  ascend.,  lobus  dexter  of  the  liver 
and  pars  descend,  duodeni. 

b.  The  posterior  surface  looks  inwards,  is  less  convex  ;  behind 
covered  by  m.  quadratus  lumborum;  separated  by  the  diaphragm 
from  the  three  last  ribs,  by  m.  psoas  from  the  vertebral  column. 

The  external,  convex  semi-elliptical  border  looks  backwards  ; 
the  internal  border  forwards,  and  is  deeply  notched  (incisura  s. 
hilus  renalis).  This  hilus  is  fifteen  to  eighteen  lines  in  length; 
behind  we  arrive  at  the  pelvis  of  the  kidney,  before  Vena  renalis. 

The  superior  border  looks  inwards,  and  is  surrounded  by  the 
suprarenal  capsules;  the  inferior  smaller  border  outwards,  and  it 
projects  down  below  the  last  rib. 

Structure  of  the  kidneys.  1.  Between  the  fatty  uniting  tissue  (capsula 
adiposa)  which  surrounds  the  kidney  and  the  Parenchyma  we  find  a  firmly 
adherent  fibrous  tunic,  prolonged  over  both  surfaces  (tunica  propria  s.  albur 
ginea~).  2.  The  tissue  of  the  gland  itself  consists  of  a  cortical  and  a  medullary 
substance. 

a.  The  cortical,  vascular  substance,  substantia  corticalis  s.  vasculosa,  [secret- 
ing portion,]  a  thin,  soft,  red,  sometimes  yellow  layer  on  the  surface  of  the 
kidney,  which  forms  columnar  processes  within  the  following  substance,  and 
thus,  septa  between  the  Malpighian  pyramids.  In  it  we  find  numerous 
fasciculi  of  very  serpentine  canaliculi,  which  terminate  in  a  cul-de-sac,  or, 
more  probably,  in  a  convoluted  form  [loops],  tubuli,  uriniferi  corticales,  which 
pass  into  the  tubular  substance.  Farther,  a  number  of  round  red  granules, 
glomerulii  s.  acini  Malpighii;  they  are  small  convolutions  of  vessels  which 
lie  between  the  windings  of  the  above  mentioned  canaliculi,  which  are 
smaller  than  they  are,  and  give  off  vasa  efferentia,  from  which  the  capillary 
network  about  the  uriniferous  tubes  and  the  commencements  of  the  renal 
veins  passes  forth. 


THE  VISCERA.  237 

b.  The  tubular  medullary  substance,  s.  tubiilosa.  s.  medullaris  [the  excretory 
portion],  paler  than  the  former,  striated  like  muscular  fibres,  consists  of 
twelve  to  fourteen  (twenty)  conical  lobes  (pyramides  Malpigtrii),  which  are 
separated  from  one  another  by  the  cortical  substance,  and  are  covered  by  the 
same  also  on  the  basis  which  is  directed  towards  the  surface  of  'the  kidney, 
whilst  the  free  apex  terminates  in  the  hilus  like  a  nipple,  as  papilla  renalis. 
There  are  generally  only  ten  to  twelve  papilla,  because  some  have  blended 
together.  Each  Malpighian  pyramid  consists  of  several  fasciculi  (these  are 
pyramides  Ferreinii}  of  parallel  canaiiculi,  tubuli  uriniferi  recti  s.  Belliniani, 
which  open  with  fine  orifices  on  the  renal  papillae,  or  rather  on  the  walls  of 
a  fossa  two  or  three  lines  deep,  inside  the  papillae,  that  is,  ductits  papittar. 
Ferrein.  The  uriniferous  tubes  consist  of.  a  clear  structureless  memb.  propria, 
and  have  a  diameter  of  0-009  to  0-016  line. 

(Renuli,  s.  bbi  renis,  is  a  name  given  to  the  Malpighian  pyramids  which  in 
early  youth,  in  animals  throughout  the  whole  of  life,  are  limited  to  the 
surface  of  the  kidney,  so  that  the  organ  appears  to  consist  of  so  many 
small  kidneys.) 

The  vessels  for  the .  most  part  go  into  the  cortical  substance.  The  great 
art.  renalis  divides  in  the  hilus  into  two  or  three  large  branches,  which  again 
divide  at  the  boundary  between  the  cortical  and  medullary  substance,  and 
form  a  capillary  network,  the  close  meshes  of  which  surround  the  basis  of 
each  Malpighian  pyramid,  dispatch  branches  thence  into  the  cortical  sub- 
stance, which  divide  in  a  forked  manner,  and  pass  along  the  undulating 
tubuli  into  the  red  granules  (acini  iT/a/p.).  Vena  renalis  passes  out  of  the  kiha 
before  the  -artery,  and  sinks  into  the  ven.  cava  inferior.  The  vessels  of  one 
lobe  do  not  communicate  with  those  of  another.  Lymphatics :  numerous,  on 
the  surface.  Nerves:  numerous,  from  plexus  Solaris,  N.  splanchnicus  minor. 
From  plexus  renalis,  plexus  spermaticus  passes  off. 

Function  of  the  kidneys :  Secretion  of  the  urine  (in  the  urinary 
canaiiculi). 

471.  2.  Excretory  ducts  of  the  kidneys.  These  are  the 
renal  calyces,  the  pelvis  renalis,  and  the  ureters. 

a.  The  Calyces  renales,  s.  infundibiila,  are  small,  membranous,  sometimes 
forked  cylinders,  which  surround  the  basis  of  one  or  more  renal  papillae. 
Their  mucous  membrane  terminates  blindly  upon  the  papillae,  but  at  the 
same  time  blind  processes  pass  into  the  substance  of  the  latter,  where  the 
urinary  canaiiculi  open.     (Henle.)     They  are  surrounded  by  the  fat  of  the 
hilus,  are  present  in,  indefinite  number  (seven  to  fourteen),  and,  arranged  in 
rows,  they  pass  into  three  branches,  which  form  again. 

b.  The  pelvis  of  the  kidney,  pelvis  renalis.     This  is  funnel-shaped,  flat 
from  before  backwards,  projects  out  behind  art.  and  ven.  renalis  from  the 
inferior  extremity  of  the  hilus,  is  very  extensible,  and  contracts  as  it  proceeds 
into: 

c.  The  ureter,  that  is  the  long  (ten  or  twelve  inches)  membranous  tube 
which  descends  on  either  side  to  the  basis  of  the  bladder.     Generally  of  the . 
thickness  of  a  raven's  or  goose's  quill ;  the  ureter  may  be,  with    its  thin 
whitish  wall,  considerably  distended.     We  find  sometimes  two  ureters  on 
one  side  if  the  renal  calyces  have  not  united  into  a  single  pelvis.     Direction: 
obliquely  downwards  and  inwards  to  the  sides  of  the  basis  oss.  sacri,  then 


238  SPECIAL  ANATOMY. 

downwards,  forwards,  and  lastly  inwards,  where,  arriving  at  the  sides  of  the 
fundus  vesicce,  it  passes  in  this  for  about  ten  lines  between  the  muscular  and 
mucous  coats,  and  opens  with  a  narrow  mouth  into  the  cavity  of  the  urinary 
bladder,  at  the  posterior  angle  of  Corp.  trigonum.  Position :  as  far  as  to  Basis 
oss.  sacri,  along  the  anterior  border  of  m.  psoas  •  behind  the  peritoneum  and 
Vasa  Spermatica  (which  cross  obliquely  with  it)  ;  the  right  ureter  (extern- 
ally) close  to  V.  cava  inferior.  At  the  basis  oss.  sacri  the  ureter  crosses  the 
vasa  lliaca  (forwards  and  inwards)  ;  in  the  small  pelvis:  with  Art.  umbili- 
calis,  vasa  obturatoria,  Vas  deferens  (in  the  male)  ;  the  superior  and  lateral 
parts  of  the  vagina  (in  the  female).  When  within  the  bladder  it  lies  behind 
Collum  uteri  (hence  retention  of  urine  at  child-birth,  &c.). 

Structure  of  the  excretory  ducts.  1.  The  mucous  membrane  is  white, 
smooth,  and  in  folds,  without  valves,  covered  with  pavement  epithelium. 
2.  The  middle  coat,  tunica  propria.  3.  The  external  coat  is  thick,  consists 
of  smooth  muscular  tissue,  the  circular  fibres  of  which  (as  in  all  excretory 
ducts  of  glands)  form  the  external,  the  longitudinal  fibres,  the  internal  thicker 
layer. 

472.     3.  The  urinary  bladder,  vesica  urinaria  s.  cystis, 

is  a  membranous,  roundish  sac  (in  the  foetus  pointed  above),  which 
is  situated  in  the  cavity  of  the  small  pelvis  close  behind  the  bones 
of  the  pubes,  and  is  for  the  purpose  of  holding  the  urine.  It  is 
held  in  its  situation  by  fascia  pelvis,  and  peritonaeum  ;  ligg.  vesi- 
calia  lateralia  (the  obliterated  artt.  umbilicales)  and  medium 
(the  obliterated  urachus) ;  ligg.  pubo-vesicalia  (3)  from  the  sym- 
physis  to  the  neck  of  the  bladder  in  the  female,  or  ligg.  pubo- 
prostatica  in  the  male.  The  capacity  of  the  bladder  is  different 
according  to  the  habits  of  individuals,  &c.,  before  birth  propor- 
tionably  larger  than  afterwards,  in  the  female  likewise  larger  than 
in  the  male,  where  it  holds  from  7  to  14  ounces  of  fluid.  Direc- 
tion of  the  axis :  from  above  and  before  downwards  and  back- 
wards. 

Divisions :  the  top,  vertex,  is  the  superior,  smallest ;  body, 
corpus,  the  central;  basis, fundus,  is  the  most  inferior  and  broad- 
est part  of  the  bladder. 

The  external  convex  surface  presents  the  following  parts : — 

1.  The  anterior  wall  is  situated  close  behind  the  symphysis,  carp.  oss.  pubis, 
and  mm.  obturat.  intern.,  with  loose,  uniting  tissue  only  interspersed,  and  with- 
out peritoneum ;  in  the  female  (because  the  prostate  is  wanting),  rather  under 
the  Symphysis ;  and  above  it,  close  behind  the  abdominal  walls,  when  the 
bladder  is  distended. 

2.  The  posterior  wall,  quite  covered  by  peritonaum,  is  situated  before  the 
rectum  (in  the  male)  ;  before  the  Uterus  (in  the  female) ;  nevertheless,  small 
intestines  generally  slip  in  between. 

3.  The  lateral  parietes,  covered  by  peritoneum,  close  to  Art.  umbilicales 
(s.  lig.  lateralis"),  and  Vasa  deferentia  (in  the  male). 

4.  The  inferior  wall,  basis,     a.  In  the  male:  above  the  vesicute  seminales 
and  Vasa  deferentia,  and  the  triangular  piece  of  the  rectum  between  them, 


THE  VISCERA.  239 

,  however,  when  the  bladder  is  empty,  is  separated  from  it  by  the 
peritonaeum.  At  the  sides  of  the  basis  are  situated :  uniting  tissue,  and  Mm. 
levatores  ani.  b.  In  the  female :  firmly  on  and  above  the  Vagina,  and  loosely 
on  the  inferior  half  of  collum  uteri. 

5.  The  superior  wall,  vertex,  apex,  is  directed  forwards  and  upwards,  and 
covered  by  the  peritonaum.     In  an  upright  position  the  intestines  rest  upon 
it.     In  front  the  urackus  s.  /<?.  suspensorium  passes  off  from  it,  ascending  to 
the  umbilicus.     This  mern', -radons  cord  is  the  remains  of  a  canal  which,  even 
in  the  human  embryo  (in  those  of  quadrupeds  it  is  certain)  up  to  the  fourth 
month,  is  said  to  pass  through  by  the  umbilical  cord  into  the  allantois.     Com- 
pare the  history  of  development 

6.  The  neck  of  the  bladder,  collum  vesica,  in  the  narrow  part  of  the  bladder, 
at  the  most  inferior  region  of  the  anterior  vesical  wall,  which  in  the  male  is 
surrounded  by  the  prostate,  and  lies  close  behind  the  inferior  border  of  the 
symphys.  pubis  (in  the  female  above  the  vagina). 

Structure  of  the  urinary  bladder:  1.  Mucous  membrane,  whitish  and  thin, 
with  a  few  mucous  follicles  (in  the  neighbourhood  of  the  neck) ;  strong 
and  sensitive,  presents  numerous  folds,  which  disappear  upon  extension  of 
the  bladder,  and  a  columnar  or  network  appearance,  according  as  the  fibres 
of  the  muscular  tunic  project.  Besides,  the  openings  of  the  two  ureters  and 
the  urethra,  between  which  arises  a  smooth  triangle,  corpus  trigonum,  bounded 
by  two  slight  folds,  plica  ureterictK,  which  are  situated  behind  the  neck  of  the 
bladder,  and  before  the  fundus  resica,  frequently  forming  a  pouch  on  either 
side  (sinus  vesical.). 

2.  The  muscular  coat  invests  the  mucous  membrane,  with  which  it  is 
united  by  a  thin  layer  of  uniting  tissue  (tunica  propria)  is  externally  thin, 
and  consists  of — 

a.  An  external  layer  of  longitudinal  fibres,  which  ascend  from  the 
neck  of  the  bladder  on  the  anterior  and  posterior  wall  to  the  vertex,  and 
pass  as  m.  detrusor  urintt. 

b.  An  internal  layer,  which  consists  partly  of  regular  or  irregular  cir- 
cular fibres  crossing  each  other  (the  first  at  the  fundus,  the  last  particu- 
larly on  the  posterior  wall),  partly  of  fibres  passing  obliquely. 

M.  Sphincter  J'esicee  is  just  such  a  fasciculus  of  circular  fibres,  which 
closes  the  orifice  of  the  urethra  into  the  bladder. 

3.  The  peritoneum  covers  the  vertex  and  the  posterior  surface  of  the  bladder 
only ;  reaches  in  the  male  (excavat.  ratfo-tesica/.)  deeper  downwards  than  in 
the  female  (excav.  vesico-uterina). 

Vessels :  Artt.  vesicales,  from  the  hypogastrica  and  its  branches.  Veins  form 
plexus  vesical.  about  the  neck  of  the  bladder,  and  open  into  V.  hypogastric. 
Lymphatics :  they  mostly  lie  between  peritoneum  and  the  muscular  coat,  and 
pass  into  plex.  hypogastric.  Nerves :  branches  of  plexus  hypogastricus  lateralis 
and  sacralis  (voluntary  and  involuntary). 

Function  of  the  bladder:  to  hold  the  urine  which  continually 
and  guttatim  flows  in  through  the  ureters,  and  when  contained  in 
sufficient  quantity,  the  resistance  of  the  sphincter  vesic.  is  over- 
come, and  it  flows  out. 


240  SPECIAL  ANATOMY. 

473.  4.  The  Urethra, 

is  the  narrow,  cylindrical  continuation  of  the  neck  of  the  bladder 
which  passes  under  the  symphysis  pubis  and  opens  with  an 
external  mouth,  osteum  cuianeum,  on  the  external  parts  of  gene- 
ration. 

a.  The  urethra  of  the  male,  urethra  virilis,  from  five  and  a 
half  to  nine  inches  long,  four  lines  broad,  passes  obliquely  for- 
wards   and   downwards    through   the  Prostate  (pars  prostat.) 
curves,  slightly  arched  downwards,  in  its  course,  under  the  Sym- 
physis (pars  membran.),  and  lies  in  a  groove  between  the  corpp. 
cavern,  on  the  inferior  surface  of  the  penis  (pars  cavernosa), 
whence  it  passes  forwards  through  the  glans  to  its  anterior  mouth. 

1.  Pars  prostatica  perforates  the  prostate  (or  lies  in  a  groove  uncovered  by 
it  above),  is  wider  at  its  departure  from  the  neck  of  the  bladder  than  before, 
and  about  ten  lines  to  one  inch  long.    On  the  posterior  wall  the  mucous  mem- 
brane forms  a  narrow  fold,  caput  gallinaginis  (colliculus  seminalis,  veru  monta- 
wwm),  upon  which  are  found  the  two  openings  of  the  ductus  ejaculatorii,  and 
on  the  sides  of  which  are  the  excretory  ducts  of  the  Prostata,  and  several  ra- 
diating bands,  frenula.     Between  Prostata  and  mucous  membrane  there  is 
placed,  as  in  the  urinary  bladder,  a  layer  of  muscular  fibres. 

2.  Pars  membranaceee  s.  isthmus  urethra,  the  narrowest  part  of  the  urethra 
(one  and  a  half  to  two  lines  diam.)  is  eight  to  nine  lines  long,  formed  only 
of  the   mucous   membrane   and    the   m.    constrictor  urethra    [Wilson's    and 
Outline's],  surrounding  it  like  a  ring,  lies  curved  under  the  Symphysis  pubis, 
separated  from  this  by  veins,  above  the  rectum  (between  the  two  a  triangular 
space,  the  apex  of  which  looks  backwards  and  upwards).     This  portion  per- 
mits   great  distension.     The  muscular  layer  is  surrounded  by  many  veins. 
[This  portion  perforates  the  two  layers  of  the  deep  perineal  fascia  about  one 
inch  below  the  angle  of  the  pubes,  three-fourths  to  a  half  below  the  subpubic 
ligament.     The  bulb  of  corp.  Spongiosum  projects  backwards  upon  its  under 
surface,  being  applied  to  the  anterior  surface  of  the  deep  fascia. J 

3.  Pars  cavernosa  s.  spongiosa,  the  longest  portion  of  the  urethra,  commences 
with  an  enlargement,  bulbus,  which  has  a  diameter  of  about  three  lines,  is 
placed  in  the  apex  of  the  pubic  angle,  is  surrounded  below  by  the  corp.  cavernos. 
[spongiosum]  urethra,  which  likewise  forms  a  bulbus,  and  laterally  by  the  mir. 
bulbo-cavernosi  and  Cowper's  glands,  and  looks  forwards  and  upwards.     From 
the  angles  in  which  the  roots  of  the  corpus  cavernos.  unite,  the  urethra  passes 
on  the  inferior  surface  of  the  penis,  at  first  above  mm.  bulbo-cavernosi,  then  close 
above  the  skin  to  the  glans ;  is  there  enlarged  (four  lines  wide,  three-quarters 
of  a  line  long)  into  the  (fossa  navicularis  s.  Morgagni),  passes  through  the 
middle  of  the  glans  [rather,  on  its  under  surface],  and  terminates  with  a  nar- 
row, oval  opening  (two  lines  wide)  at  its  point.     This  portion  consists  of  a 
fibrous  sheath,  a  spongy  body,  and  the  mucous  membrane,  which  here  pre- 
sents particular  longitudinal  folds,  and  the  oblique  mouths  of  Cowper's  glands 
directed  forwards,  and  those  of  mucous  glands  (g/.  Littrii)  in  larger  depressions 
(lacunae,  s.  sinus  Morgagni). 

Vessels  of  the  urethra  are  numerous,  especially  in  the  fossa  navicularis. 
Nerves  also  from  pudendo-hamorrhoidal. 

b.  The  urethra  of  the  female,  urethra  muliebris,  about  an  inch 
and  a  half  long,  and  wider  than  that  of  the  male;  passes,  only 


THE  VISCERA.  241 

slightly  curved,  under  the  symphysis  pubis,  from  the  neck  of  the 
bladder  forwards  and  downwards,  contracts  by  degrees  and  opens 
into  vestibulum  vaginse.  Above  a  venous  plexus  surrounds  it 
and  ligg.pubo  vesicalia;  under  the  symphysis:  the  angle  of  the 
united  crura  of  the  Clitoris;  below  it  rests  firmly  upon  the  an- 
terior wall  of  the  Vagina.  The  external  mouth,  surrounded  by 
a  small  enlargement,  lies  about  one  inch  under  the  Clitoris  above 
the  entrance  to  the  Vagina.  Its  mucous  membrane  presents 
longitudinal  folds,  and  the  veins  passing  longitudinally,  also,  a 
few  openings  of  mucous  crypts ;  the  external  coat  consists  of  a 
thin  layer  of  erectile  tissue  (like  corp.  cavernosum  urethrse 
virilis)  and  a  thicker  of  circular  muscular  fibres  (pubo-urethralis). 

474.  The  glandulx  supra-renales,  renes  succenturiati, 

are  two  small  (one  inch  high,  two  inches  broad),  flat,  semilunar 
shaped  and  spongy  blood  glands,  which  in  the  foetus  and  child 
are  larger  than  in  the  adult,  and  surround  the  superior  extremity 
of  the  kidneys  like  a  helmet. 

The  anterior  surface  of  the  right  supra-renal  capsule  looks 
towards  the  inferior  surface  of  the  liver,  to  the  right  of  V.  cava 
inferior;  that  of  the  left  touches  the  Pancreas  and  looks  towards 
thefundus  of  the  stomach.  The  posterior  surface  is  attached  to 
the  superior  part  of  the  cms  of  the  diaphragm,  on  a  plane  with 
the  tenth  dorsal  vertebra,  and  has  the  Nn.  splanchnic,  major  and 
gland,  semilunare  behind  and  close  to  it.  The  superior  convex 
border  is  thin,  and  looks  upwards  and  inwards.  The  inferior 
concave  is  thick  and  lies  upon  the  kidney.  The  surface  is  sur- 
rounded by  a  thin  layer  of  adipose  tissue  (not  by  peritoneum)  and 
a  fibrous  coat. 

Structure.  We  distinguish  a  thick,  external  cortical  substance,  of  a  yellow 
striped  appearance;  and  a  pultaceous,  chestnut  brown,  medullary  substance, 
in  the  interior,  which  is  penetrated  by  numerous  vessels  (veins).  The  lobes 
perceptible  upon  the  surface,  only,  are  formed  by  the  furrows  for  vessels. 

Vessels:  very  numerous;  suprarenales,  branches  of  phrenic,  infer.;  Aorta; 
codiaca  renalis.  Veins :  give  rise  to  the  idea  of  a  cavity  in  the  supra  renal 
capsules;  they  pass  into  F.  cava  infer,  (the  right)  and  renalis  (the  left). 

Nerves :  from  plcx.  renalis  and  Solaris. 

Function  of  the  supra  renal  capsules  unknown. 

475.  The  Genitals,  Organs  of  Generation,  Organa  genitalia 

s.  sexualia. 

I.  Of  the  Male,  Genitalia  virilia, 

serve  for  the  preparation,  preservation,  and  excretion  of  the  semi- 
nal fluid,  and  are  placed  for  the  most  part  outside  the  pelvic 
cavity. 
16 


242  SPECIAL  ANATOMY. 


476.  1.  The  Scrotum,  o 

is  a  pouch-like  elongation  of  the  external  skin  which  hangs  down 
before  the  perinaeum  between  the  legs,  and  encloses  both  the 
testicles. 

This  skin  is  brownish,  thin,  and  without  adipose  tissue, 
wrinkled,  loose,  and  large  in  warmth,  dense,  strong,  and  tightly 
applied  in  the  cold  ;  beset  with  delicate  and  curled  (it  is  said  ob- 
liquely placed)  hairs  and  many  sebaceous  glands. 

In  its  centre  a  linear  suture-like  elevation,  raphe,  passes  from 
the  anus  to  the  root  of  the  penis,  which  is  bounded  before  by  the 
root  of  the  penis  [sometimes  extends  along  it]  behind  by  the 
anus,  and  indicates  the  place  where  inside  the  Scrotum  a  vertical 
septum  passes  off  from  the  Dartos  between  the  testicles  —  tunica 
dartos,  is  a  red,  dense,  and  very  vascular  membrane  of  contractile 
uniting  tissue,  which  is  firmly  applied  to  the  internal  surface  of 
the  scrotum,  and  only  loosely  to  the  tun.  vaginalis  communis. 
The  uniting  tissue  between  the  last  continues  into  the  fascia 
femor.  and  abdominal,  superfic.,  and  becomes  changed  by  pres- 
sure into  a  membrane  (e.  g.,  of  water).  The  partition  in  the 
central  line,  septum  scroll,  consists  of  fibrous  and  common  uniting 
tissue.  The  dartos  above,  close  to  the  spermatic  cords,  is  sup- 
plied with  uniting  tissue  containing  much  adipose,  and  it  does 
not  pass  into  the  fascia  superficialis. 

Vessels  :  Jirtt.  and  Vv.  scrotales  anteriores  (branches  of  pudenda  externa  and 
epigastrica)  ;  posteriores  (branches  of  pudenda  communis"). 

Lymphatics:  numerous;  they  enter  into  the  inguinal  glands. 

Nerves  :  branches  of  the  ileo-inguinal.,  spermatic,  extern,  pudendus  and  cutan. 
femor.  posterior  communis. 

477.  2.  The   testicles,  testes,  testiculi  s.  didymi,  are   two 
oval  glands  lying  under  the  penis,  which  until  towards  the  end  of 
embryonic  existence  lie  in  the  abdomen,  but  later,  enveloped  in 
a  peculiar  and  common  vaginal  membrane,  inside  the  Scrotum, 
and  the  left  rather  lower  than  the  right.     Length  :  two  inches. 
Breadth:  one  inch.     Thickness:  six  lines.     Weight:  one  half  to 
one  ounce.     Each  testicle  consists  of  two  parts. 

a.  The  proper  testicle,  testis,  op^t'j,  is  egg-shaped,  rather  flat  on 
the  sides,  smooth,  and  yielding  (about  as  much  as  the  eye),  of  a 
whiter  hue  (tunica  albuginea).  Its  superior  extremity  looks 
forwards,  the  inferior  backwards  ;  the  anterior  border  downwards, 
the  posterior  with  the  epididymis,  upwards. 

Structure.  The  parenchyma  (pulpa  testis)  is  soft,  doughy,  yellowish  red  ; 
it  consists,  principally,  like  that  of  the  kidney,  of  numerous  and  many  times 
convoluted  tubules,  tubuli  scmiferi,  which,  surrounded  by  capillary  and  nervous 
rete,  are  associated  by  uniting  tissue  into  longitudinal  lobules,  and  are  sur- 
rounded as  a  whole  by  a  fibrous  capsule  (tunica  albuginea  s.propria),  which 


THE  VISCERA.  243 

last  again  involves  itself  in  a  serous  sac  (tun.  vaginalis  propria  testis).  The 
tubuli  semiferi  commence  in  blind  (or  looped  T)  extremities,  at  the  periphery 
of  the  testicle,  and  form,  by  means  of  their  many  short  convolutions,  a  dense 
cortical  layer,  which  consists  of  from  one  to  two  hundred  lobules  (which  un- 
folded measure  about  from  one  thousand  to  one  thousand  two  hundred  feet 
long).  The  lobules  are  supported  by  processes  from  the  tunica  albuginea, 
which  at  the  posterior  border  of  the  testicle  forms  a  triangular  space,  corpus 
Highmori,  and  continues  inwards.  From  this  carp.  Highmori  the  tubuli  pass 
almost  directly  straight,  when  they  have  passed  away  from  the  lobules,  and 
then  unite  at  an  acute  angle  into  a  rete,  rete  vasculosum  Halleri.  From  these 
arise  from  nine  to  thirty  vasa  efferentia  testis,  which  perforate  the  superior- 
extremity  of  the  Corpus  Highm.,  and  pass  into  the  head  of  the  Epididymis. 
They  are  many  times  convoluted,  present  (each)  a  conical  cord,  conus  vascu- 
losus  Halleri,  the  point  of  which  is  directed  downwards,  and  they  finally  unite 
to  form  the  Canal  of  the  epididymis. 

The  seminal  tubules  consist  (like  the  urinary)  of  a  structureless  membrane, 
have  a  diameter  of  0- 1 1  to  O24  of  a  line,  and  contain  the  Spermatic  filaments 
(spermatozoa')  and  the  other  elements  of  the  Semen. 

b.  The  Epididymis  s.  parastata  cirsoides,  is  the  vermiform 
appendix,  two  and  a  half  to  three  inches  long,  which  is  placed 
along  the  posterior  border  of  the  testicle  somewhat  externally,  of 
a  brownish  red,  and  flattened  from  above  to  below.  Its  thicker 
and  broader  superior  extremity,  caput  epididymis,  rests  with  its 
concave  surface  close  upon  the  superior  extremity  of  the  testicle ; 
the  central  part,  corpus,  is  surrounded  all  round  by  tun.  vaginal. ; 
the  inferior  thinner  and  narrower  portion,  cauda,  is  again  situated 
close  on  the  inferior  extremity  of  the  testicle,  and  continues, 
curved  downwards,  into  the  vas  deferens. 

Structure.  The  epididymis  consists  of  a  single  tube,  O12  to  O33  lines  in 
diameter,  and  so  often  convoluted  that  its  length  measures  thirty-two  feet 
(Monro),  and  is  a  continuation  of  the  ront  vasculosi.  which  coalesce  in  the  caput 
epididymis.  Vasculwn  aberrans  Halleri  is  a  still  more  minute  canal  than  that 
of  the  epididymis,  which  passes  upwards  from  the  tail  of  the  last  to  the  vas 
deferens,  and  is  then  lost;  it  arises  from  the  departure  of  a  few  seminal  vessels 
in  the  endeavour  to  form  a  second  epididymis,-  according  to  Weber  similar 
blind  canals  are  sometimes  present  in  the  duct,  hepatic,  and  pancreatic. 

Vessels  of  the  testicle:  Art.  and  V.  spermatica  inter na;  the  veins  arise  from 
the  plexus  pampiniformis. 

Lymphatics :  plexus  spermaticus. 

Nerves :  plexus  spermaticus  (from  plex.  renalis  n.  sympatici). 

Tunica  vaginalis  propria  testis,  the  serous  envelope  (Perito- 
naeum) of  the  testicle,  is  a  completely  closed  sac,  in  which  it  is 
involved  (like  the  lungs  in  the  pleura),  so  that  the  one  (internal) 
layer  (t.  serosa  testis  or  visceral)  is  connected  firmly  with  the 
testicle  (t.  adnata),  the  other  (external)  surrounds  it  loosely  [t. 
vaginalis  reflexa  or  parietal],  and  a  cavity  is  found  between  the 
two,  in  which  a  serous  fluid  is  exhaled.  The  reflection  of  the 
external  layer  upon  the  testicle  takes  place  at  its  posterior  border, 
at  the  corpus  Highmori.  The  epididymis  is  separated  from  the 


244  SPECIAL  ANATOMY. 

superior  border  of  the  testicle,  externally  by  a  kind  of  mesentery, 
lig.  epididymidis  s.  mesorchium,  and  internally  it  is  covered 
higher  up. 

The  development  of  the  vaginal  membrane  into  a  closed  sac  is 
closely  connected  with  the  descent  of  the  testicle. 

Descensus  tesliculi. — In  the  tenth  to  twelfth  week  of  foetal  life  we  see  a 
small  elongated  testicle,  in  a  mesentery  which  passes  off  from  the  peritonaeum 
of  the  posterior  abdominal  wall,  below  the  kidney.  In  the  fissure  which 
leads  to  it  from  the  posterior  abdominal  wall,  the  vasa  testiculi  are  situated, 
in  the  centre  the  vas  deferens,  below,  a  fibrous  thicker  cord  projects  from  it 
into  the  short  straight  inguinal  canal. 

The  leading  string,  gubernaculwn  Hunteri,  which  is  widely  fixed  to  the 
Scrotum.  The  testicle  increases  by  degrees,  not  so  the  gubernaculum,  which 
becomes  shortened  in  proportion  to  the  other  parts,  and  draws  down  the 
testicle  out  of  the  mesenteric  fold,  so  that  the  immediately  investing  and 
closely  attached  portion,  only  (the  subsequent  tun.  serosa  testis),of  the  testicle, 
accompanies  it. 

hi  its  passage  through  the  inguinal  canal,  the  testicle  draws  down  with  it 
that  portion  of  the  peritonaeum  which  is  connected  with  its  covering;  a  cavity 
appears  therefore  inside  the  scrotum,  on  the  external  surface  of  which  the 
testicle,  with  its  vessels,  &c.,  is  situated,  and  which  is  separated  from  the 
cavity  of  the  peritoneum  by  a  constriction  only,  the  vaginal  canal,  canalis 
vaginalis.  (Intestines  pass  through  this  canal,  in  hernia  congenita ;  thus  they 
are  only  separated  from  the  Parenchyma  of  the  testicle  [the  tunica  albuginea] 
by  the  serous  investment  of  each  other,  whilst  in  hernia  acquesita,  two  folds  of 
peritonceum,  namely,  the  hernial  sac  and  tunica  vaginalis  testis  [reftexa],  lie 
there  between  them). 

So  soon  as  the  testicle  has  arrived  at  the  fundus  of  the  scrotum,  the  obli- 
teration of  the  vaginal  canal  commences,  as  the  tunica  becomes  converted  into 
a  ligamentous  band  of  uniting  tissue,  habercula,  between  the  internal  inguinal 
ring  and  the  superior  extremity  of  the  testicle. 

These  filaments  even  sometimes  disappear.  The  obliteration  commences 
above  or  below,  or  from  both  points  at  the  same  time,  towards  the  termination 
of  foetal  life ;  at  birth  the  canal  is  frequently  open,  and  intestines  fall  into  it, 
forming  a  hernia  (hernia  inguinalis  congenita).  Serum  collecting  in  it  forms 
a  Hydrocde. 

478.  3.  The  vas  s.  ductus  defer  ens, 

the  continuation  of  the  epididymis,  commences  at  the  cauda  of 
the  last,  ascends  through  the  inguinal  canal,  together  with  the 
remaining  parts  of  the  spermatic  cord  into  the  abdomen,  and 
terminates  before  the  vesiculse  seminales,  associated  with  the 
excretory  duct,  of  which  it  forms  the  ductus  ejaculatorius.  In 
its  course  we  distinguish  four  parts. 

a.  Pars  testicularis  passes  in  a  serpentine  form  from  behind 
forwards  and  from  below  upwards  along  the  inner  side  of  the  art. 
ven.  and  spermatica  and  the  epididymis. 

b.  Pars  funicularis,  ascends  in  a  proper  sheath  behind  art. 
and  ven.  spermat.,  directly  as  far  as  the  inguinal  canal,  inside  of 
the  spermatic  cord. 


THE  VISCERA.  245 

c.  Pars  inguinalis,  passes  through  the  inguinal  canal,  inclin- 
ing from  below,  upwards,  from  within,  outwards  and  from  before, 
backwards,  continues  over  the  curvature  of  the  art.  epigastrica 
forming  a  part  of  the  spermatic  cord. 

d.  Pars  vesicalis  sinks  downwards,  at  its  exit  from  the  inguinal 
canal  and  the  cord  directly  into  the  pelvis,  over  Vasa  epigastricse, 
at  first  on  the  side,  then  on  the  posterior  surface  of  the  urinary 
bladder,  where  it  crosses  obliquely  the  Art.  umbiliccdis,  and  be- 
takes itself  inwards  and  downwards  to  the  fundus  vesicx  before 
the  ureter,  then  passes  transversely  inwards  to  the  inner  side  of 
the  vesicidse  seminales,  where  both  vasa  defer entia  almost  meet 
together,  and  join  behind  the  prostata,  with  the  anterior  extremi- 
ties of  the  seminal  vesicles  at  an  acute  angle.     Two  inches  above 
the  vesiculx  seminales  it  is  thinner  and  wider. 

Structure.  Cylindrical,  with  thick  walls,  hard,  narrow,  and  only  at  its 
inferior  extremity  expanded;  this  canal  presents  an  extremely  delicate, 
white,  and  folded  mucous  membrane,  surrounded  by  a  compact  contractile 
coat,  and  an  external  uniting  tissue.  Muscular  fibres  exist  in  large  animals 
(horses)  indubitably.  Arter.:  spermaticaititernaa.n<lvesicaL;  very  numerous 
inwards  towards  the  seminal  vesicles. 

The  spermatic  cord,  funiculus  spermaticus,  a  looser  cord  at 
the  posterior  part  of  the  testicle,  which,  passing  with  and  into  the 
testicle,  through  the  inguinal  canal  as  far  as  the  internal  ring,  is 
composed  of  the  following  parts,  viz. : 

1.  Vas  deferens  (with  Jlrt.  and   Ven.  sperniatica  deferens,  from  vesicalis  in- 
ferior: only  sometimes)  ;  at  the  internal  posterior  part. 

2.  Art.  sperniatica  inter via,  on  the  anterior  and  external  side  of  the  vas  de- 
ferens. 

3.  Ven.  spermatic,  interna,  with  plexus  pampiniformis. 

4.  Plexus  spermatic,  lymphaticus. 

5.  Nerv.  spermaticus  extern,  (branches  of  genito-cruralis\  Plcx.  spermatic,  (n. 
symphaticus). 

6.  Habercula  (the  obliterated  tunica  propria  testis),  and  sometimes 

7.  Vasculum  aberrans  Halleri. 

The  above  mentioned  parts  are  united  by  an  adipose  uniting  tissue  (tun. 
propria  funwuli),  and  they  are  held  firmly  together  by  the 

Tunica  vaginalis  communis  testiculi  et  funiculi.  This  last 
is  a  fibrous  membrane,  covered  by  m.  cremaster,  which  surrounds 
the  tunica  propria  of  the  testicle,  and  is  connected  through  the 
inguinal  canal  with  the  uniting  tissue  between  fascia  trans^ersa- 
lis  and  peritoneum.  (It  becomes  thicker  and  stronger  from  pres- 
sure, e.  g.,  of  fluid.) 

479.  4.    Vesiculss  seminales  s.  spermaticse, 

two  longish,  flattened,  irregular  sacs,  between  the  rectum  and 
bladder,  along  the  external  side  of  the  vasa  deferentia,  lying  at 
the  anterior  extremity  close  to  one  another  and  diverging  back- 


246  SPECIAL  ANATOMY. 

wards.  Length  :  from  two  to  two  inches  and  a  half.  Breadth  : 
six  lines.  Depth :  from  two  to  three  lines.  The  internal  surface 
consists  of  a  cavity  divided  into  from  ten  to  fifteen  compartments 
(of  about  six  to  eight  lines  long),  is  striated  and  in  folds,  like  the 
vas  deferens,  the  external  coat  of  which,  however,  is  thicker. 
They  contain  a  yellowish  brown  viscous  fluid.  The  anterior 
pointed  extremity  of  each  seminal  vesicle,  which  is  surrounded 
by  the  Prostata,  forms  the  excretory  duct  which,  united  with  the 
vas  defer  ens  of  each  side,  passes  into  the  ductus  ejaculatorius,  the 
ejaculatory  duct  for  the  semen,  which,  likewise,  very  short,  but 
with  thin  walls,  oblique  from  above,  downwards  and  inwards 
through  the  basis  prostatse,  opens  upon  the  veru  montanum  of 
the  urethra,  with  a  narrow  mouth,  whilst  its  posterior  extremity 
is  wider. 

Function  of  the  testicle.  It  is  to  secrete  the  semen,  which, 
preserved  in  the  seminal  vesicles,  is  carried  through  the  ductus 
ejaculatorius  into  the  urethra,  and  there  mixes  with  the  fluids  of 
the  Prostate,  and  the  glands  of  Cowper. 

480.  5.  The  prostate  gland,  glandula  prostata, 
a  whitish  conical  gland,  blunted  in  front,  twelve  lines  thick,  fifteen 
long  and  eighteen  broad,  placed  behind  and  below  the  Symphys. 
pubis,  before  the  neck  of  the  bladder  and  the  rectum,  rather  ob- 
liquely from  above  and  behind  to  below  and  before ;  and  is  per- 
forated by  the  urethra  and  the  ductus  ejaculatorii.  Its  inferior 
surface  rests  upon  the  anterior  surface  of  the  rectum,  attached  by 
uniting  tissue,  is  flat,  and  in  the  centre  separated  by  a  longitudinal 
groove  into  two  equal  parts. 

The  superior  surface  lies  under  the  ligg.  pubo-prostatica,  and 
some  lines  below  the  pubic  angle.  The  sides  are  surrounded  by 
M.  levator  ani.  The  basis,  that  is,  the  posterior  extremity,  pre- 
sents two  larger  lateral  lobes  and  a  central,  bean-shaped,  hidden 
between  the  two,  surrounding  the  neck  of  the  bladder,  and  farther 
backwards  the  narrow  portion  of  the  seminal  vesicles.  The  blunt 
apex  directed  forwards  and  downwards  terminates  behind  the  pars 
membran.  urethras.  The  canal  for  the  urethra  is  situated  rather 
above  the  centre,  is  often  open  above,  and  placed  in  rare  cases  on 
the  inferior  surface  of  the  Prostata. 

Structure.  The  Parenchyma  of  the  Prostate,  which  consists  of  lobule?* 
forms  roundish  glandular  cells  of  fibrous  tissue,  surrounded  by  vascular  rete. 
The  cells,  closely  compressed  together,  are  connected  with  one  another  by 
small  canals,  from  the  junction  of  which  from  twelve  to  fifteen  excretory 
ducts  are  formed,  which  pass  obliquely  from  behind  forwards  in  the  gland, 
and  open  close  to  the  veru  montanum,  with  very  fine  orifices,  into  the  urethra, 
lor  the  purpose  of  discharging  a  whitish  viscous  fluid,  liquor  prcataticus.  The 
fibrous  envelope  of  the  prostate  gives  to  it  its  external  firmness,  whilst  the 


THE  VISCERA.  247 

substance  itself  is  easily  lacerable.  M.  transfers,  prostata — only  exists  in 
muscular  men. 

Am.  they  come  from  A.  vesical.,  fuemorrhoid.,  media  or  vesicales.  The  veins 
are  numerous ;  its  plexus  is  connected  with  pi.  vesical.  and  htemorrhoidalis. 

Nerves :  they  are  branches  of  pi.  hypogast.  nerv.  sympathici. 

481.  6.  Cowper's  glands,  glandulas  Cowperi, 

are  two  irregular  glands,  the  size  of  a  pea  and  yellowish  red,  the 
lobes  of  which,  consisting  of  small  fossae,  open  into  two  or  three 
excretory  ducts,  common  to  them  all,  which,  after  a  passage  of 
one  and  a  half  to  two  inches  on  the  inferior 'wall  of  the  urethra, 
penetrate,  obliquely,  the  mucous  membrane  at  the  commencement 
of  pars,  cavernos.  urethras.  They  lie  close  before  the  prostate, 
under  the  bulbus  urethras  [rather  behind  it]  between  the  two  in. 
constrict,  isthmi  urethras,  surrounded  by  m.  bulbo-cavernosi ; 
and  secrete  a  yellowish  mucus. 

482.  7.  The  male  organ,  membrum  virile,  penis,  virga,  coles, 

is  a  cylindrical,  spongy  body,  in  a  state  of  erection  three-cornered 
(and  then  eight  inches  long),  on  the  inferior  surface  of  which  the 
pars  cavernosa  \_spongiosa~]  urethras  is  applied.  Its  posterior 
extremity,  radix  s.  crura  penis,  is  thicker  and  attached  on  either 
side  to  the  pelvis ;  its  anterior  extremity,  nut,  glans,  pointed  and 
rounded  ;  its  superior  surface,  dor  sum,  flattened  and  presenting  a 
longitudinal  sulcus  for  vasa  dor  s  alia  penis ;  its  inferior  surface  is 
convex,  and  presents  the  urethrae  in  a  deep  groove. 

The  penis  consists  of  the  corp.  cavernosum  penis,  the  pars 
cavernosa  urethrae  with  its  corpus  cavernosum  [spongiosum~], 
the  glans  and  muscles  (which  see). 

a.  Corpus  cavernosum  (s.  corpora  cavernosa]  penis,  is  a  roundish  body,  spring- 
ing with  two  roots  from  the  internal  surfaces  of  the  rami  ascend,  oss.  Ischii 
(close  above  the  tuber  Ischii],  which  passes  away  from  under  the  symphysis 
pubis,  where  its  roots  lie  close  together,  as  far  as  the  glans,  into  which  its  an- 
terior rounded  and  smaller  extremity  projects,  without  communicating  with 
it.  On  its  superior  surface  the  vasa  dorsalia  penis  pass,  in  its  inferior  deep 
groove,  the  pars  cavernosa  of  the  urethra.  A  fibrous  vertical  partition,  septum 
penis,  separates  the  two  halves  of  the  corpus  cavernosum  (hence  the  appella- 
tion two  corpp.  cavernosa],  which,  however,  are  more  or  less  connected  together, 
since  the  veins  of  the  one  pass  over  into  those  of  the  other  side. 

Structure.  The  cavernous  bodies  consist  of,  1.  a  thick,  strong,  and  exten- 
sible fibrous  envelope,  albuginea,  from  which  a  septum  passes  off  in  the  cen- 
tre; 2.  of  an  erectile  tissue,  tela  erectilis,  which  consists  of  cylindrical  fasciculi 
of  uniting  tissue,  which  cross  each  other  very  frequently ;  contain  a  blood- 
vessel and  form,  with  the  processes  (bands,  trabecula)  passing  off  from  the 
albuginta,  cellular  spaces.  The  small  cells  communicate  with  one  another. 
In  them  is  placed  a  very  convoluted  vascular  rete,  the  principal  mass  of 
which  is  formed  of  veins  which  consist  of  tunica  vasorum  cotwnunis,  only.  They 


248  SPECIAL  ANATOMY. 

pass  very  much  convolved  into  their  plexus  cavernosus,  and  still  even  present 
enlargements,  sinus  venosi,  although  unusually  large.  A  portion  of  the  arteries 
(Artt.  helicincR  Mutter},  which  contribute  towards  erection,  are  said  to  open  di- 
rectly into  these  sinuses. 

b.  Corpus  cavernosum  urethra,  the  spongy  body  of  the  urethra,  which  it  sur- 
rounds like  a  sheath,  and  extends  from  the  symphysis,  where  it  is  surrounded 
by  m.  bulbo-cavernosus,  and  swells  out  like  a  bulb  (bulbus  cavernosus)  [spon- 
giosum],  to  the  inferior  surface  of  the  penis,  as  far  as  the  glans,  without  com- 
municating with  the  corpus  cavernosum  penis,  but  with  the  glans.     Its  struc- 
ture is  just  the  same  as  the  last,  only  the  septum  is  wanting. 

c.  The  nut,  glans  penis,  £aX*vo?,  the  anterior  blunted,  conical  extremity  of 
the  member,  is  perforated  by  the  urethra,  the  elongated  opening  of  which  it 
presents  at  its  apex.     The  excavated  basis  of  the  glans  projects  over  the  corp. 
cavern,  penis,  which  lies  within  it,  so  that  an  enlarged  border,  distinctly  beset 
with  nervous  papillae,  corona  glandis,  appears.     The  superior  convex  surface 
is  smooth,  the  inferior  flat  surface  smaller,  and  divided  by  a  longitudinal  sulcus 
into  two  tubercles,  between  which,  as  far  inwards  as  the  corona,  the  cord. 
(frenulum  praputii)  is  attached,  which  is  a  fold  of  the  prepuce.     The  paren- 
chyma of  the  glans  is  of  the  same  character  as  that  of  the  spongy  body,  only 
more  closely  compressed.     It  is  connected  with  the  corp.  cavernos.  urethra. 

d.  The  external  coverings  of  the  penis. 

1.  Fascia  penis,  a  continuation  of  /.  perinai,  forms  the  lig.  pubo-prostaticum, 
which  extends  from  the  roots  of  the  corp.  cavern,  penis  to  the  lig.  arcuatum,  and 
is  perforated  by  the  urethra  ;  covers  upon  the  dorsum  of  the  penis  the  Vasa 
dorsalia,  and  reaches  as  far  as  the  glans. 

2.  The  external  skin,  attached  by  loose  uniting  tissue,  destitute  of  fat,  to  the 
fascia,  is  very  thin,  brownish,  hairless,  and  moveable,  and  by  these  circum- 
stances is  distinguished  from  the  skin  above  and  behind  the  root  of  the  penis, 
on  the  pubes,  mons  veneris.     Behind  the   corona  glandis  the  skin,  instead  of 
passing  over  directly  upon  it,  leaves  the  glans,  passes  away  as  far  as  over  the 
orifice  of  the  urethra,  is  then  reflected,  and  goes  as  far  back  as  the  posterior 
lx>rder  of  the  glans ;  very  delicate,  vascular,  and  firmly  attached  to  the  last 
and  to  the  mucous  membrane  of  the  urethra.     Thus  the  foreskin  (praputium) 
arises,  a  free  sheath,  consisting  of  two  layers,  the  internal  of  which  is  attached 
as  frenulum  prceputii  to  the  inferior  surface  of  the  glans,  and  behind  corona 
glandis  is  beset  with  numerous  sebaceous  glands,  glandula  praputiales  s.  odori- 
fera  TysoniancE,  and  secretes  the  smegma  prapulii.     The  opening  of  the  pre- 
puce is  frequently  too  much  contracted,  the  frenulum  too  long,  as  it  reaches  as 
far  as  the  orifice  of  the  urethra. 

3.  Lig.  suspensorium  penis,  a  triangular,  yellow,  elastic  band  in  the  central 
line  between  Symphisis  pubis  and  corp.  cavernosum  penis,  serving  to  fasten  it,  is 
a  continuation  of  the  decussation  of  lig.  Pouparti.     It  does  not  possess  mus- 
cular fibres  (m. pubo-cavernosus,  sometimes;  it  is  a  portion  of  bulbo-cavernosus) . 

The  vessels  of  the  Penis :  Arter.  profunda  penis  goes  partly  into  the  veins, 
partly  into  the  blindly  terminating  (Miiller)  or  looped  Jlrt.  helicina  projecting 
into  the  sinus  of  the  veins;  art.  dor  salts  penis.  Veins:  dorsalis  penis  (forms  a 
sinus),  only  one,  between  two  arteries. 

Nerves :  N.  pudendus  communis ;  plexus  cavernosus  N.  sympathici,  most  of  the 
branches  to  the  glans.  After  division  of  the  n.  dorsalis  penis,  the  corp.  caver- 
nosa  collapse,  become  more  vascular,  but  incapable  of  erection. 


THE  VISCERA.  249 

II.  The  Organs  of  Generation  in  the  Female, 

Genitalia  muliebria. 
They  are  situated,  for  the  most  part,  within  the  pelvic  cavity. 

483.  1.  The  ovaries,  ovaria  s.  testes,  muliebres  (Galen),  are 
two  semioval  whitish  glands,  flattened  from  before  to  behind, 
transverse  at  the  entrance  of  the  small  pelvis,  one  of  which  is 
situated  on  either  side  of  the  uterus,  behind  and  below  the  Fallo- 
pian tube.     The  convex  anterior  and  posterior  surfaces  and  the 
superior  border  are  free  (enveloped  in  peritonaeum) ;  the  straight 
or  concave  inferior  border,  where  the  vessels  and  nerves  pass  in 
(hilus  ovam),  is  connected  with  the  broad  ligament  of  the  uterus  ; 
the  internal  extremity  by  a  fibrous  cord,  Kg.  ovarii,  with  the 
superior  angle  of  the  Uterus ;  the  external  extremity  with  the 
fringe  of  the  tuba  Fallopix.     The  surface  of  the  ovaries  is  not 
always  irregular  and  uneven. 

.  In  the  virgin  :  Length :  eighteen  to  twenty-three  lines  ;  breadth : 
nine  to  twelve  lines ;  thickness :  four  and  a  half  to  five  lines ; 
weight :  eighty  to  a  hundred  and  ten  grains. 

In  women  of  thirty-five  to  forty  years  old :  Length  :  twelve  to 
eighteen  lines;  breadth  :  six  to  seven;  thickness:  three  to  four; 
weight:  forty  grains. 

Position  :  in  the  fo?tus  in  the  regio  lumbalis  (like  the  testicles); 
during  pregnancy  in  the  abdominal  cavity,  also  after  delivery  in 
the  fossse  iliacse;  and  very  frequently  behind  the  Uterus. 

Structure.  The  parenchyma  of  the  ovary  is  immediately  covered  by 
(fibrous)  uniting  tissue,  tunica  propria  s.  albuginea,  which  receives  a  serous 
investment  from  the  peritoneum,  so  that  the  fossa  of  the  fnlus  ovarii  only 
remains  free.  The  parenchyma  itself  (strotna)  consists  of  a  loose,  but  yet 
dense  uniting  tissue,  penetrated  by  numerous  blood-vessels,  and  containing 
twelve  to  fifteen  roundish,  transparent  vesicles,  of  one  half  to  four  lines 
diam.;  these  are,  foUindi  s.  vesiculee  (ovula)  Graafii,  the  largest  of  which  lie 
close  to  the  periphery.  In  impregnation,  a  Graafian  vesicle  bursts  after  it 
has  filled  with  blood ;  it  is  emptied  of  its  contents,  the  blood  changes  colour, 
and  is  metamorphosed  into  the  cicatrizing  matter,  which  is  corpus  luteum,  the 
yellow  body. 

484.  The  Graafian  vesicle  is  to  be  regarded  as  a  cell  of  the  ovary.     It 
consists  of  a  very  vascular,  dense  tunica  propria  (theca,  of  Baer)  which  en- 
closes a  clear  fluid,  mixed  with  some    fat   globules  and  with   elementary 
granules  only,  and  the  ovum.     Each  granule  forms  a  connected  layer  of  cells 
(inembrana  granw/osa),  which  covers  the  internal  surface  of  the  vesicle,  and 
attaches  the  ovum  to  its  wall,  since  it  surrounds  it  above  and  below,  like  Epi- 
thelium. 

The  egg,  ovulum,  appears  to  the  unassisted  eye  as  a  white  pnnctule,  is  still 
covered  on  its  exit  from  the  Graafian  vesicle  by  a  remnant  of  the  granular 
layer  (that  is,  discus  proligerus  of  Baer),  which  is  lost  upon  the  entrance  of 
the  egg  into  the  Fallopian  tube.  It  is  0-08  of  a  line  in  size,  consists  of  a  clear, 
structureless,  firm,  and  close  envelope,  chorion,  and  fluid  contents,  the  yelk. 


250  SPECIAL  ANATOMY. 

Ckorion,  yelk  membrane,  is  single,  indivisible  (a  zona  pellurida,  that  is  to 
say,  a  space  filled  with  fluid  between  the  yelk  and  the  membrana  granulosa 
does  not  exist).  The  yelk  contains  a  thick  mass  of  whitish  yellow,  brilliant 
granules  and  globules,  the  size  of  which  equals  the  fat  globules.  Surrounded 
by,  and  close  beneath  the  Chorion,  lies  the 

Germinal,  or  vesicle  of  Purkinje,  vesicula  germinativa.  It  is  round,  clear  as 
water,  and  so  much  the  larger  the  smaller  the  egg,  consists  of  a  smooth,  struc- 
tureless membrane,  and  contains,  besides,  a  very  clear  albuminous  fluid,  a 
dark  granule,  the  germinal  spot  (macula  germinativa), 

Vessels  of  the  Ovary.  Arter. :  ovarica  branches  of  the  uterina.  Veins  and 
lymphatics  like  the  arteries. 

Nerves:  plex.  spermat.  intern,  from  sympathicus. 

485.  2.  The  Fallopian  tubes,  tubas  Fallopise,  two  membra- 
nous  tubes,   four  inches    long,  lying   transversely  between  the 
Uterus  and  the   external  wall  of  the  pelvic   entrance  (one  upon 
etiher  side),  before  and  above  the  ovary,  behind  the  round  liga- 
ment.   The  external  extremity,  extremitas  abdominalis,  consists 
of  thin,  extensible  walls,  curves  backwards  and  inwards  towards 
the  external  extremity  of  the  ovary,  and  opens  with  an  orifice  a 
line  wide  into  the  abdominal  cavity,  surrounded  by  fringed  lobules, 
Jimbrise  latinise  s.  morsus  diaboli.     One  of  these  lobules  (the 
innermost)  is  connected  by  means  of  a  ligament  with  the  Ovarium, 
which  it  surrounds  like  a  funnel,  in  consequence  of  the  flow  of 
blood  to  it  after  conception.     The  inner  extremity,  extrem.  ute- 
rina,  is  firm,  and  not  extensible,  and  opens  into  the  cavity  of  the 
Uterus  at  the  superior  angle  with  a  very  narrow  orifice  (one  fourth 
of  a  line)  obliquely  inwards  and  downwards.     A  (narrow)  canal 
consequently  leads  from  the  cavity  of  the   Uterus  directly  into 
the  cavity  of  the  abdomen. 

Structure.  The  tuba  consists  of  three  coats:  a.  The  serous  coat  (perito- 
neum) ;  a  continuation  of  the  Kg.  uteri  latum  passes  to  the  external  orifice, 
where  it  also  passes  on  to  the  fringe  and  over  into  the  mucous  membrane 
(the  only  instance  of  such  a  transition) ;  the  peritoneum  is  likewise  open  at 
this  point. 

b.  The   central,  very  vascular   coat,    a   continuation  of  the  tissue  of  the 
Uterus,  contains,  in  the  larger  animals  at  least,  muscular  fibres ;  the  internal 
fibres  pass  longitudinally ;  the  external  transversely. 

c.  The  innermost  coat,  mucous  membrane,  presents,  especially  at  the  ex- 
ternal extremity,  many  longitudinal  folds,  rugae  longitudinal.,  and  passes  into 
the  tunica  serosa.      Arteries ;  from  the  uterina  and  spermat.  interna.  Veins ;  in 
the  plex.  pampiniform.  and  v.  uterina. 

Function  :  a.  The  conveyance  of  the  male  semen  to  the  ovary 
(?).  b.  The  reception  and  conveyance  of  the  ovum  from  the 
ovary  into  the  Uterus. 

486.  3.  The  Womb,  Uterus, 

a  pear-shaped  bag,  flattened  from  before  to  behind  ;  its  broadest 
closed  extremity  directed  upwards,  its  narrow  open  extremity 


THE  VISCERA.  251 

downwards ;  it  lies  in  the  centre  of  the  small  pelvis,  between  the 
urinary  bladder  and  rectum,  above  the  Vagina,  in  a  fold  of  the 
peritoneum;  very  moveable.  Direction:  oblique  from  above 
downwards,  and  from  before  backwards;  sometimes,  but  gene- 
rally in  pregnancy,  from  above  downwards,  and  from  right  to 
left.  Dimensions :  in  the  mature  virgin  two  and  a  half  to  three 
inches  deep,  six  lines  thick,  above  sixteen  to  eighteen  broad;  at 
the  neck  six  lines  broad;  weight:  six  to  ten  drachms. 

We  distinguish  the  following  parts:  the  base,  fundus,  the  most 
superior,  broadest,  and  convex ;  corpus,  the  central,  longer;  col/um, 
the  most  inferior  and  narrowest  portion,  which  passes  obliquely 
downwards  and  backwards,  and  projects  with  its  rounded  ex- 
tremity freely  into  the  Vagina.  This  vaginal  portion,  porlio 
vaginalts,  in  front  six,  behind  five  lines  long,  presents  upon  its 
inferior  uneven  surface,  the  so-called  os  lincae,  a  transverse  fissure, 
that  is,  the  external  opening  of  the  Uterus,  orificium  uteri  ex- 
ternum,  which  is  bounded  before  by  a  thick  and  long  lip  (labium 
anterus),  behind  by  a  thinner  and  shorter  lip  (labium  post erius), 
which  are  smooth  in  the  virgin,  but  otherwise  indented.  The 
anterior  surface  a  little  convex,  covered  as  far  as  the  neck  by 
peritoneum,  is  attached  from  the  neck  downwards  by  loose  uniting 
tissue  to  the  fundus  of  the  urinary  bladder.  The  posterior  surface 
convex,  entirely  covered  by  the  peritoneum,  lies  on  the  anterior 
wall  of  the  rectum.  The  superior  border  convex,  does  not  reach 
as  high  as  the  pelvic  inlet.  The  lateral  borders  form,  with  the 
superior  of  either  side,  an  angle,  where  the  tuba  opens ;  and  under 
that  the  lig.  rotundum  is  attached.  Ligg.  lata  adhere  to  them. 

The  cavity,  cavum  uteri,  is  narrow ;  and  in  the  fundus  and 
corpus  triangular;  the  apex  leads  into  the  cylindrical  canal  of  the 
neck  through  the  internal  mouth  of  the  Uterus,  orific.  uteri  in- 
ternum.  The  walls  are  four  to  six  lines  thick,  the  thinnest  (two 
lines)  at  the  place  where  the  tubse  are  affixed. 

Structure  of  the  Uterus.  The  parenchyma  is  grayish-brown,  very  dense 
and  firm,  and  consists  of  several  layers  of  a  very  thick  fibrous  tissue,  which 
in  the  gravid  state  and  in  animals  is  regarded  as  muscular  substance.  It  is 
penetrated  by  numerous  vessels  (veins).  At  the  collum  we  see  only  circular 
fibres  crossing  at  acute  angles ;  on  the  body  and  fundus  a  superficial  layer  of 
longitudinal  and  oblique  fibres,  which  converge  to  the  lateral  borders,  «nd  a 
deep  layer  of  circular  fibres.  In  the  unimpregnated  uterus  the  fibres  are 
similar  to  the  undeveloped  of  the  Embryo. 

2.  The  mucous  membrane,  which  lines  the  cavity  of  the  ufcrus,  is  a  con- 
tinuation of  that  of  the  Vagina,  but  very  thin,  and  firmly  attached,  beset  with 
numerous  mucous  follicles,  which,  when  filled,  resemble  vesicles  (vesirula  s. 
ovula  Nabothi),  and,  in  consequence  of  their  capillary  vascular  rete,  have  a 
red  appearance.  In  the  neck  it  is  whiter,  thicker,  and  presents  on  the  ante- 
rior and  posterior  wall  longitudinal  folds,  which,  from  their  conjoined  trans- 


252  SPECIAL  ANATOMY. 

verse  folds,  look  like  a  palm  leaf  (plicae,  palmatce,  arbor  vita  uteri),  and  after 
one  pregnancy  (not  always)  disappear. 

3.  The  serous  coat.  The  external  surface  of  the  uterus  is  covered  by  peri- 
toneum, in  front  as  far  as  the  commencement,  behind  deeper  downwards,  to 
the  middle  of  the  collum,  which,  from  the  urinary  bladder  to  the  uterus,  forms 
ligg-  vesico-uterina,  and,  passing  from  this  over  upon  the  rectum,  it  forms  ligg. 
recto-uterina.  On  the  sides  of  the  Uterus  the  peritoneum  forms  two  folds: 

The  broad  ligaments  of  the  uterus,  ligg.  uteri  lata,  which  pass  transversely 
from  the  internal  surface  of  the  external  pelvic  wall  (at  the  pelvic  inlet)  to 
the  Uterus,  and  each  (of  the  two)  consists  of  two  layers,  between  which  are 
situated  at  the  superior  free  border  the  tuba;  under  that  the  lig.  ovarii;  and 
behind  that  the  ovarium  itself,  whereby  an  expansion  like  a  bat's  wing  arises, 
ala  vespertilionis.  Before  the  broad  ligaments  an  actual  fibrous  band  lies  on 
either  lateral  border  of  the  uterus  : 

Lig.  uteri  rotundum  s.  crus  uteri,  round  ligament  of  the  uterus,  which  goes 
off  from  the  uterus  close  under  the  tuba,  consists,  like  this,  of  muscular  tissue, 
and  is  placed  in  a  particular  fold  of  the  anterior  layer  of  lig.  uteri  latum:  as- 
csnds  externally  to  the  internal  inguinal  ring,  then  passes  forwards  and  down- 
wards through  the  inguinal  canal,  covered  by  a  serous  sheath  and  muscular 
fibres  (like  m.  cremasler),  to  the  mons  veneris.  It  serves  for  the  fixation  of  the 
uterus  (and,  from  its  large  supply  of  blood,  to  conduct  it  to  this  organ). 

Vessels :  Jlrt.  uterina  are  branches  of  hypogast.  or  umbilicalis ;  pass  in  a  very 
serpentine  course,  and  often  anastomose  with  spermatica  intern.  Veins :  plex. 
uierini  open  into  the  vv.  uterinte  and  spermatica;  they  form  sinuses  in  the  sub- 
stance of  the  mucous  membrane.  Lymphatics ;  very  numerous  and  strong, 
especially  upon  the  surface ;  passing  between  the  lig.  lata,  they  open  into  the 
plex.  hypogastric. 

Nerves :  branches  of  plex.  hypogastricus  superior  (of  sympathic.),  and  lateralis 
(of  sympath.  and  sacral  nerves)  ;  they  enter  the  substance  of  the  Uterus. 

Function  of  the  Uterus:  1.  Formation  of  the  embryo.  2.  Se- 
paration of  the  menstrual  blood  [probably  from  veins]. 

487.  4.  The  Vagina, 

a  membranous  cylinder  from  three  to  seven  inches  long,  one  inch 
wide,  flattened  and  curved  from  behind  forwards,  is  situated 
between  the  bladder  and  rectum,  vulva  and  uterus,  and  forms 
with  the  last  a  concave  angle  forwards. 

The  superior,  widest  portion,  fundus  s.  fornix  vaginse,  sur- 
rounds, intimately  united  to  it,  the  vaginal  portion  of  the  neck  of 
the  Uterus.  The  inferior,  narrow  extremity,  surrounded  by  m. 
constrictor  vaginse,  forms  the  entrance  to  the  Vagina,  introitus 
vaginas,  which  is  partly  closed  by  a  crescentic  fold  of  mucous 
membrane  lying  at  the  inferior  border  (the  membrane  of  the  virgin, 
Hymen).  (As  the  remains  of  the  Hymen,  torn  during  copulation, 
we  observe  two  to  five  small  lobules,  the  so-called,  carunculx 
myrtiformes;  according  to  Lauth  they  are,  however,  present  close 
to  the  Hymen.  The  Hymen  is  sometimes  found,  notwithstanding 
the  performance  of  coitus ;  but  it  is  sometimes  wanting  even  in 
the  newly-born).  The  anterior  wall  rather  concave,  shorter  than 


THE  VISCERA.  253 

the  posterior,  is  placed  behind  the  urethra  and  the  base  of  the 
bladder,  which  are  firmly  united  with  it.  The  posterior  wall, 
above  convex,  below  concave,  about  half  an  inch  longer,  abuts 
upon  the  rectum.  At  the  sides,  the  ligg.  lata  are  attached  above, 
the/0sc.  pelvis  and  m.  levator,  below. 

Structure.  The  vagina  consists  of  a  spongy,  erectile,  very  vascular  tissue 
(like  corpp.  cavernosd),  which  is  enclosed  by  an  external  very  dense  and 
strong,  and  an  internal  less  thick  fibrous  coat.  The  internal  surface  is  lined 
by  a  firmly  attached  reddish  mucous  membrane,  through  the  thick  Epithelium 
of  which  numerous  mucous  follicles  and  villi  are  distinguishable.  Transverse 
columnar  folds  are  placed  on  both  sides  of  the  middle  line  on  the  anterior  and 
posterior  wall,  these  are  columna  rugarum,  anterior  and  posterior.  They  dis- 
appear at  the  superior  part  after  delivery. — The  serous  membrane  (perito- 
neum) at  the  posterior  uppermost  part. 

Vessels :  Jlrtt.  vaginales,  branches  of  the  hypogastrica,  the  uterina,  vesicates. 
Veins :  plexus  vaginalis  upon  the  anterior  and  posterior  wall  (containing  fre- 
quently phlebolithes) . 

Nerves :  Branches  of  plex.  hypogastric.  lateralis  (of  sympathicus ;  3 — 4.  Sa- 
cral nerves). 

488.  5.  The  Vulva, 

lies,  in  the  regio  pubis  under  the  mons  Veneris,  about  an  inch 
before  the  orificium  ani,  and  consists  of  the  large  and  small 
pudendal  lips,  the  clitoris  and  the  vestibule. 

a.  The  great  or  external  lips,  labiapudendi  majora,  the  parallel 
folds  of  skin,  passing  from  above  downwards  and  behind  for- 
wards, which  are  beset  with  hair  and  cushioned  with  fat  (like 
mons  Veneris),  which  cover  the  rest  of  the  pudendal  parts,  have 
a   longitudinal    fissure,   "n'raa?  vulvse"   between   them.      The 
superior  angle  is  designated  commissura  anterior,  the  inferior  c. 
posterior.     At  the  inferior  commissura  a  thin  membranous  fold, 
frenulum  labiorum,  which  in  delivery  is  generally  torn ;  and  the 

space  between  the  frenulum  and  the  Hymen,  the  fossa  navicu- 
laris.  The  internal  surface  is  smooth,  like  mucous  membrane, 
and  passes  into  the  internal  lips. 

Arter.:  labiales  post,  (of  pudenda  intern.)  ;  labial,  anterr.  (of  pudenda  extern.) 
Nerves :  from  ileo-hypogastric.,  spermatic,  from  the  inguinal  canal. 

b.  The  internal  or  small  pudendal  lips,  1.  p.  minora  s.  nymphse, 
the  narrow  folds  of  mucous  membrane  on  the  internal  surface  of 
the  great  lips,  having  the  vestibule  between  them.     Above  they 
become  broader  and  divide  into  two  rami,  the  superior  of  which 
blends,  above    the  clitoris,  with  the  prseputium  clitoridis,  the 
inferior,  losing  itself  in  the  clitoris,  forms  the  frenulum  clitoridis. 
Between  the  layers  of  the  fold  an  erectile  tissue  is  found  [which 
presents  an  enlargement  below ;  in  fact  corresponds  to,  and  is  of 
the  same  structure  as  the  bulb  of  the  Corp.  Spongiosum  of  the 


254  SPECIAL  ANATOMY. 

male.  TRANS.]  At  birth  the  internal  lips  are  larger  than  the  ex- 
ternal; in  women  who  have  frequently  given  birth  to  children,  and 
are  thin  [even  during  pregnancy],  they  project  out  beyond  the 
great  lips ;  in  the  Hottentot  women  they  form  the  so-called 
"  aprons." 

c.  The  Clitoris — an  erectile  organ,  like  the  corpus  cavernosum 
penis — lying  close  under,  the  anterior  commissure  between  the 
great  lips,  surrounded  by  fat  and  a  fibrous  sheath.     Commonly 
one  inch  long,  three  lines  thick,  it  often  becomes  much  larger,  and 
then  might  be  taken  for  a  penis,  (but  it  is  not  perforated  by  the 
urethra,  and  the  corp.  spongiosum  urethras  is  wanting  in  it).     It 
arises  with  two  roots,  from  the  ram.  adscendent.  oss.  ischii,  which 
are  united  below  the  symphysis  pubes,  and  thus  terminated,  a  few 
lines  before  the  symphysis,  with  a  roundish    extremity,  glans 
clitoridis;  prepuce  andfrenulum  exist.    Lig.  suspensorium  and 
Mm.  ischio-cavernosi,  as  in  the  penis.    M.  constrictor  vaginas 
(this  corresponds  with  m.  bulbo-cavernosus  penis).    Arter. :  pro- 

funda  and  dorsal,  clitorid.  from  pudenda  interna. 

d.  The  vestibule,  vestibulum  Vaginae,  that  is,  the  floor  of  the 
pudendal  fissure,  between  the  clitoris  and  the  inferior  commissure ; 
bounded  laterally  by  the  nymphae.     A  superior  opening  is  found 
therein,  the  orificium  urethras  one  inch  [less]  under  the  clitoris, 
surrounded  by  a  slight  elevation  and  radiating  folds ;  and  lower 
down  the  entrance  to  the  Vagina.     Mucous  follicles  are  found, 
particularly  in  the  region  of  the  orifice  of  the  urethra ;  sebaceous 
glands,  which  secrete  a  caseous  substance  of  a  peculiar  smell  upon 
the  nymphae. 

e.  Glandulss  Bartholinianse,  (again  made  known  by  Tiedemann 
in  1840)  s.  Duverneianse  s.  Cowperi,  two  flat,  almost  bean  shaped, 
reddish  white,  hardish  glands;  of  five  to  ten  lines  long,  lie  in  a 
considerable  quantity  of  fat,  at  the  sides  of  introitus  vaginas  (one 
on  either  side)  beneath  the  external  skin  of  the  inferior  part  of 
labia  majora  and  fill  up  the  space,  between  the  extremity  of  the 
vagina,  ram.  ascend,  ischii  and  crura  and  erector  clitoridis,  be- 
fore the  m.  transvers.  perinaei. 

Structure.  The  glands  consist  of  small,  flat  rounded,  and  conglomerate 
lobules,  in  which  arises  a  membranous  excretory  duct,  from  caecal  vesicles, 
eight  lines  long,  which  passes  out  at  the  anterior  border  of  the  superior  part 
of  the  glands,  before  m.  constrictor  vagince,  passes  behind  the  labia  majora  hori- 
zontally, inwards  and  forwards,  and  opens  with  a  wider  orifice  at  the  sides 
of  the  vestibulum  Vagince. 

Arteries :  these  are  branches  of  pudenda  interna  and  vaginales. 

Nerves :  delicate  twigs  of  n.  pudendus. 

489.       6.  The  breasts,  mammary  glands,  mammae, 
are  two  semi-globular  or  conical  (in  Spanish  women)  glands  on 


THE  VISCERA.  255 

the  anterior  surface  of  the  Thorax  (before  the  third  to  the  sixth 
ribs)  covered  with  fat  and  a  delicate  smooth  skin,  in  the  centre  of 
which  rises  the  conical  teat,  or  nipple,  papilla  mamma,  surrounded 
by  a  rosy  or  brownish  halo,  areola.  The  bosom,  sinus,  is  the 
space  between  the  two  mammae. 

Structure.  The  gland,  freed  from  fat,  is  flattish,  round,  and  rests  upon  the 
ra.  pectoral  maj.,  with  its  flat  base,  separated  by  fasc.  superficialis.  The  sur- 
face is  irregular,  because  the  gland  chiefly  consists  of  irregular  lobules,  which 
are  associated  together  by  uniting  and  adipose  tissue,  but  do  not  communicate 
with  one  another.  [They  are  placed  in  a  fibrous  tissse,  a  kind  of  proper 
fascia,  pointed  out  by  Sir  Astley  Cooper,  in  his  work  on  the  Breast.  THAXS.] 
The  lobules  again  consist  of  roundish  vesicles  arranged  together,  like  a  bunch 
of  grapes  (acini,  cellula,  vesiculee),  the  white  excretory  ducts  of  which  unite 
together  to  form  a  large  milk  duct,  ductus  lactiferi,  of  which  twelve  to  twenty 
finally  remain  passing  inwards  towards  the  central  point  of  the  gland,  and 
open  in  the  nipple,  between  the  wrinkles  of  the  skin,  either  singly,  or  two  or 
three  united  together. 

The  vesicles  consist  of  fibrous  tissue,  which  also  unites  the  lobules  and 
Drives  to  the  gland  its  firmness.  The  milk  ducts  are  surrounded  by  erectile 
tissue  both  in  the  areola,  where  they  form  enlargements,  and  in  the  nipple 
itself,  in  consequence  of  which  the  nipple  in  suckling,  or  from  physical 
causes,  becomes  erect 

In  tlie  male  breast  the  vesicles  and  ducts  are  wanting. 

Vessels:  Branches  of  artt.  mammariee  extern^  very  strong  during  suckling' 
Veins:  circulus  venosus  areola ;  they  open  into  Vv.  mammar.  extern.  Lympha- 
tics :  they  enter  the  axillary  glands  and  plex.  mammarius. 

Nerves :  Branches  of  nn.  supraclaviculares  from  the  fourth  cervical  nerve  to  the 
skin;  very  delicate  twigs  probably  enter  the  gland  with  the  arteries.  [Fila- 
ments of  nervi  ititercostalesJ] 


OF  THE  SENSES, 

ORGANA  SENSORIA. 


"  We  observe  in  the  eye  many  exquisite  refinements  of  construction,  by 
which  various  defects,  unavoidable  in  all  optical  instruments  of  human  work- 
manship, are  remedied.  Of  this  nature  are  those  which  render  the  organ 
achromatic,  which  correct  the  spherical  aberration,  and  which  provide  for  the 
adjustment  of  its  refracting  powers  to  the  different  distances  of  the  objects 
viewed ;  not  to  speak  of  all  the  external  apparatus  for  the  protection,  the 
preservation,  and  the  movements  of  the  eyeball,  and  for  contributing  in  every 
way  to  the  proper  performance  of  its  office.  Are  not  all  these  irrefragable 
proofs  of  the  continuity  of  the  same  design  ;  and  are  they  not  calculated  still 
farther  to  exalt  our  ideas  of  the  Divine  Intelligence,  of  the  elaborate  perfec- 
tion impressed  upon  His  works,  and  of  the  comprehensive  views  of  His 
providence  ?" — ROGET.  Bridgewater  Treatise,  vol.  i.  p.  32. 


17 


OF  THE  SENSES. 

LITERATURE. 

Organs  of  the  Senses  : — 

Dalrymple.    Anatomy  of  the  Human  Eye.     1834. 
Jacob.    Art.  "  Eye11  in  Cycl.  of  Anat.  and  Phys.  and  Med.  Chir.  Trans. 

vol.  xii.     1823.— Phil.  Trans.    1819. 
Porterfield.    A  Treatise  on  the  Eye.     1769. 
Valentin.     On  the  Functions  of  the  Nerves  of  the  Orbit,  transl.  by  J.  F. 

France.     Lond.  Med.  Gaz.  1846. 

Owen.     Catal.  of  Hunt.  Museum.     Phys.  Series,  vol.  iii. 
Jones,   Wharton.    Med.  Gazette,  vol.  xxi.,  and  Mackenzie's  Treatise  on 

Diseases  of  the  Eye,  for  a  Section  of  the  Eye. 
Carter,  H.  J.    Med.  Gazette.    Jan.  1839. 
Brewster.    Philos.  Trans.  1833—1836. 

Ear:  — 

Tod,  D.    Anat.  and  Phys.  of  the  Organ  of  Hearing.     1832. 
Art.  "  Organ  of  Hearing,11  in  Cycl.  Anat.  and  Phys.,  with  Bibliog. 
Pitcher.     On  the  Structure,  &c.  of  the  Ear.     1838. 
Saunders.    Anatomy  of  the  Human  Ear,  &c.     Plates.     1806. 

Nose  :— 
Paget.    Art.  "Nose"  Cycl.  of  Anat.  and  Phys. 


259 


OF  THE  SENSES,  ORGANA  SENSORIA. 

490.  1 .  The  organ  of  Sight,  the  Eye,  Organon  visus,  oculus. 

The  eye  is  placed  in  the  orbit  (see  Osteology),  and  is  moved,  for 
the  complete  performance  of  its  functions,  by  six  proper  muscles, 
(see  Myology),  protected  by  certain  contrivances,  and  by  others 
maintained  in  a  lubricated  state. 

A.  Accessory  Organs,  Tutamina  oculi. 

491.  1.  The  eyebrows,  supercilia, 

two  arched  enlargements  of  the  skin  along  the  superior  border  of  the 
basis  of  the  orbits,  are  beset  with  short,  stiff  hairs,  directed  towards 
the  temples,  which  are  arranged  more  closely,  inwards  towards  the 
nose,  and  are,  rarely  only,  continued  over  the  root  of  the  nose 
(by  intercilia).  The  skin  is  thick,  lies  firmly  upon  a  muscular 
layer  of  m.frontcdis,  orbicular,  and  superciliaris  ;  is  provided  with 
numerous  nerves  from  n.facialis  and  trigeminus,  and  with  vessels 
from  ophthalmicm  and  temporalis.  Uses :  The  eyebrows  protect 
the  eyes  against  too  strong  light,  and  from  the  perspiration  flowing 
down  from  the  forehead ;  they  serve,  besides,  for  the  expression  of 
the  face. 

492.  2.  The  eyelids,  palpebra, 

two  movable  cutaneous  curtains,  which,  passing  off  from  the  su- 
perior and  inferior  border  of  the  base  of  the  orbits  completely  shut 
up  the  eye  when  they  are  approximated.  They  consist  of  skin, 
muscular  fibres,  cartilage  and  mucous  membrane.  The  anterior 
or  cutaneous  surface  is  convex,  and  folded  across ;  the  posterior 
surface  turned  towards  the  globe  of  the  eye,  concave  and  beset 
with  yellowish,  vertical  lines  (glandul.  Meibom.).  The  free  bor- 
ders are  in  the  open  eye  curvilinear,  and  they  bound  an  elliptical 
space,  in  the  closed  eye  rectilinear,  and  only  leave  a  narrow  fis- 
sure, rima  palpebrar.^  but  not  a  triangular  canal  between  them. 
The  anterior  edge  of  the  free  borders  is  beset  with  three  rows  of 
short,  stiff  and  curved  hairs,  cilia,  eyelashes,  the  points  of  which 
diverge  from  one  another ;  the  posterior  edge  presents  a  regular  row 
of  (twenty-five  to  thirty)  small  openings  (see  Meibomian  Glands, 
§  493.)  At  the  last  [internal]  one-sixth  of  the  free  border,  it  presents 
a  tubercle  provided  with  an  opening,  the  lacrymal punctum.  From 
this  point  inwards  there  are  neither  cilia  nor  openings  any  longer 


260  SPECIAL  ANATOMY. 

present.  The  free  borders  unite  together,  and  form  towards  the 
temples  the  external  acute  angle,  commissura  externa  s.  canthus 
minor i  which  leads  into  a  depression  (of  the  conjunctiva) ;  towards 
the  nose  (at  the  posterior  border  of  proc.  ascendens  maxilL  super. \ 
the  internal  rounded  and  wider  angle,  commissura  interna  s.  can- 
thus  major.  The  superior  eyelid  is  deeper  than  the  inferior. 

a.  The  cartilages  of  the  eyelids,  tarsi,  tarsal  cartilages,  are  thin  fibro-car- 
tilaginous  plates,  which  are  placed  towards  the  free  border  of  the  eyelids  ;  the 
superior  four,  the  inferior  two  lines,  deep.     Their  anterior  convex  surface  is 
covered  by  m.  orbicularis ;  the  posterior  is  firmly  united  with  the  conjunc- 
tiva ;  the  free  border  is  thick,  the  attached  thin,  in  the  superior  eyelid  convex 
(here  is  affixed  the  m.  levator  palpebr.  super.),  and  it  continues  into  a  fibrous 
membrane,  which  externally,  very  strong  at  the  basis  orbitce,  internally  loses 
itself  in  uniting  tissue. 

The  two  tarsi  do  not  reach  to  the  angles  of  the  eye,  but  become  united  to 
them  by  the  tarsai  ligaments : 

Lig.  palpebrale  internum,  a  flat  ligament,  with  its  surfaces  directed  up- 
wards and  downwards,  its  borders  forwards  and  backwards,  which 
passes  away  transversely  inwards,  before  the  lacrymal  sac,  to  the 
place  where  the  frontal  and  superior  maxillary  bones  (proc.  frontalis.) 
unite  together ;  and 

Lig.  palpebrale  externum,  which  passes  off  from  the  external  extremity 
of  the  tarsi  (in  a  forked  manner)  protected  by  fibrous  tissue,  passes  to 
the  proc.  frontal,  of  the  malar  bone  inside  the  orbit,  and  is  attached  to 
its  external  angle. 

b.  The  external  skin  of  the  eyelids  is  thin,  rather  transparent,  attached  by 
loose  but  fatless  uniting  tissue  to  the  pale  internal  portion  of  m.  orbicularis, 
connected  firmly  with  the  tarsi,  and  passes  over  on  the  free  border  of  the 
eyelids  into 

c.  The  uniting  membrane  of  the  eyelids,  conjunctiva  palpebrarum.    It  is  a 
soft,  mucous  membrane,  covered  with  epithelium,  provided  with  nerves  and 
vessels,  which  covers  the  free  border  and  the  posterior  surface  of  the  eyelids, 
is  reflected  at  the  margins  of  the  orbits  from  the  lids  upon  the  globe,  forms 
at  the  external  angle  of  the  eye  a  depression,  at  the  internal  (where  is  the 
so-called  lacus  lacrymalis)  a  semilunar  fold,  concave  towards  the  temples ;  this 
is,  plica  semilunaris  (memb.  nictitans,  of  animals).     On  the  globe  of  the  eye, 
the  anterior  third  of  which  it  covers,  the  conjunctiva  is  only  loosely  connected 
with  the  sclerotica,  but  the  more  intimately  with  the  cornea.     It  enters  into 
the  lacrymal  canals  at  the  puncta,  and  lines  them. 

Vessels  and  nerves  of  the  eyelids.  Artt.  palpebrales  (interna  et  externa)  are 
branches  of  art.  ophthalmica,  temporalis,  infraorbitalis  andfacialis;  they  form 
an  arcus  palpebralis  (s.  tarseus}  superior  and  inferior.  The  veins  of  the  same 
name  open  into  Vv.  angularis  and  temporalis  (facial,  anter.  and  posterior). 
Conjunct,  palpebrar.  is  plentifully  supplied  with  bloodvessels,  less  so  the  conj. 
sclerotica,  not  at  all  the  conj.  cornece,  in  which  Arnold  has  found  Lymphatics. 


THE  SENSES.  261 

Nerves:  they  are  branches  oftrigeminus  (frontal.,  lacrymal.,  infraorbital., 
infratrochlearis) ;  facialis  (to  m.  orbicular.)  ;  oculomotor ius  (to  levat.  palpe- 
brar.) 

493.  The  glands  of  the  eyelids. 

a.  The  glands  of  Meibomius,  gl.  Meibomiance,  lie  in  the  substance  of  the 
tarsal  cartilages  (twenty  to  twenty-five  in  the  inferior,  thirty  in  the  superior), 
are  rather  lower  than  the  last,  and  open  on  the  posterior  edge  of  the  free 
border  of  the  lid,  in  a  row.     Each  gland  consists  of  a  convoluted  tube,  the 
walls  of  which  are  cellular  all  round,  so  that  it  looks  like  a  bunch  composed 
of  berries  united  together  without  stalks,  is  formed  of  uniting  tissue,  filled 
with  flat  cells  and  fat  vesicles,  and  pours  out  a  viscous  fluid  which  prevents 
the  overflow  of  the  tears  (lema).    The  short  excretory  duct  of  one  gland  some- 
times unites  with  that  of  another,  or  is  fissured. 

b.  Caruncula  lacrymalis,  is  a  flesh-like  corpuscle,  the  size  of  a  grain  of 
rye  at  the  internal  canthus,  internal  to  plica  semilunaris ,  covered  by  the  con- 
junctiva ;  it  consists  of  an  assemblage  of  glandules  of  the  same  kind  as  the 
Meibomian,  from  which  (seven  or  eight)  minute  openings  proceed,  and  upon 
which  light,  short,  small  hairs  are  seen. 

494.  4.  The  lacrymal  organs,  organa  lacrymalia. 

a.  The  lacrymal  gland,  glandula  lacrymalis  (innominata),  consists  of  two 
parts,  both  of  which  are  situated  above  the  external  canthus. 

The  superior  or  orbital  portion,  of  the  size  of  an  oat  grain,  lies  transversely 
with  the  superior  convex  surface  attached  to  ihefovea  lacrymal.  of  the  frontal 
bone,  with  the  inferior  concave  surface  upon  m.  rectus  externus  ;  its  anterior 
border  close  behind  the  superior  external  border  of  the  orbit,  and  the  upper 
lid  ;  on  its  posterior  border  nerves  and  vessels  enter. 

The  inferior  or  palpebral  portion  is  smaller,  thinner,  situated,  covered  by 
a  fibrous  membrane,  upon  the  external  side  of  the  upper  lid,  and  reaches 
downwards  almost  to  the  superior  border  of  the  tarsus  superior.  The  ten  or 
twelve  excretory  ducts  of  both  parts  open  (almost  invisibly)  on  the  posterior 
surface  of  the  upper  lid,  one  line  above  the  cartilage,  from  the  external  angle 
as  far  as  the  centre  of  the  lid,  in  a  row,  and  perforate  the  conjunctiva.  Arter. : 
art.  lacrymalis.  Nerves :  a  branch  of  sympathicus  ;  n.  lacrymal.  (trigemin.) 
passes,  nominally  only,  through  it  to  the  conjunctiva,  like  n.  facialis  in  the 
Parotis. 

b.  The  puncta  and  lacrymal  canals.     The  circular,  constantly  open  punc- 
tum  lacrymali,  is  found  at  the  apex  of  a  small  tubercle  (papilla  lacrymalis)  on 
the  internal  part  of  the  free  border  of  the  eyelid.     The  superior  looks  down- 
wards and  backwards,  the  inferior  upwards  and  backwards  towards  the 
globe.     Both  lead  into  the  lacrymal  canaliculi,  canaliculi  lacrymales  a.  cornua 
limacum.     They  pass  at  the  commencement  vertically,  immediately  bend  at 
a  right  angle,  inside  the  free  border  of  the  eyelids,  inwards  and  open,  inde- 


262  SPECIAL  ANATOMY. 

pendently,  in  the  anterior  external  part  of  the  lacrymal  sac,  behind  lig.  pal- 
pebrale  internum.  The  commencement  is  somewhat  wider  than  the  remain- 
ing part,  in  the  whole  a  capillary  tubule  ;  the  walls  thick  and  elastic,  covered 
before  by  fibres  of  m.  orbicularis,  behind  by  fibres  of  m.  Horneri,  consist  of 
mucous  membrane. 

Muse.  Horneri  [tensor  tarsi]  arises  from  the  crista  lacrymalis,  passes 
transversely  outwards,  is  divided  by  lig.  palpebr.  intern.,  and  attaches 
itself  to  the  internal  angle  of  the  eye,  drawing  the  lids  inwards,  and 
making  the  puncta  deeper  in  the  lacus  lacrymalis,  where  they  take  up 
the  lacrymal  moisture  and  carry  it  into 

c.  The  lacrymal  sac  and  duct.  These  two  form  one  canal  (canalis  lacry- 
malis oss.  utiguis),  which  extends  from  the  eye  as  far  as  the  nose  ;  secretes  a 
mucous  fluid,  and  carries  this,  together  with  the  tears,  into  the  nose.  The 
lacrymal  sac,  saccus  lacrymal.,  an  oblong  but  closed  sac,  formed  of  soft,  red- 
dish mucous  membrane,  united  by  areolar  tissue  on  the  inner  side  with  the 
fossa  lacrymal.  (os  unguis  and  proc.  nasalis  of  the  upper  ^aw)  on  the  external 
with  a  fibrous  continuation  of  m.  orbicularis  ;  it  lies,  close  behind  the  internal 
inferior  angle  of  basis  orbitce,  behind  and  under  the  lig.  palpebrale  intern., 
above  which  the  caecal  extremity  of  the  sac,  only,  projects  a  little  upwards. 
On  the  external  surface  is  placed  m.  Horneri.  The  lacrymal  canaliculi  open 
close  behind  lig.  palpebr.  Below  it  continues  into  the 

Lacrymal  duct,  ductus  (naso-)  lacrymalis  a  membranous  canal  flattened  on 
the  sides,  somewhat  contracted  in  the  centre,  which,  slightly  curved  forwards 
and  outwards,  descends  in  the  osseous  canalis  lacrymalis  to  the  nasal  cavity, 
and  opens  into  the  inferior  nasal  chamber  below  the  anterior  part  of  the 
inferior  turbinate  bone  (sometimes  in  a  fold  of  mucous  membrane  which 
elongates  the  ducts  a  few  lines).  Internally  it  lies  on  the  meatus  narium  and 
concha  inferior;  externally  on  the  thin  wall  of  the  antrum  Highmori. 
Arter. :  branches  of  ophthalmica.  Nerves:  infra-  and  supra-trochlearis 
(nerv.  ophthalmici). 

495.  5.  The  muscles  of  the  eyes. 

These  are  placed  together  inside  the  orbits,  in  the  depth  of 
which  they  arise  and  form  a  circle  around  the  N.  opticus  and  the 
nerves  of  motion. 

a.  M.  lev.  palpeb.  superioris  (see  Myologia). 

b.  Mm.  recti  bulbi  oculi,  the  four  straight  muscles  of  the  eye. 

Origins:  round  about  the  foramen  opticum.  Insertions:  with  a  broader 
aponeurosis  to  the  Sclerotica,  convex  towards  the  Cornea  and  in  its  proximity. 
Position:  one  surface  turned  towards  the  walls  of  the  orbit,  the  other  towards 
the  optic  nerve  and  the  globe  of  the  eye ;  separated  from  these  by  adipose 
tissue  and  vessels ;  in  a  straight  direction  from  behind  forwards,  curved  on 
the  globe.  The  opening  in  the  capsule  for  reel,  intern,  is  rather  higher  than 
the  internal,  for  reef,  extern,  on  the  same  plane  with  the  external  angle  of  the 


THE  SENSES.  263 

eye,  for  rect.  super,  and  infer,  rather  inwards  of  the  vertical  diameter  (Wil- 
brand).  Use :  each  draws  the  globe  towards  its  own  side ;  associated  they 
draw  it  inwards,  with  the  exception  of  the  rect.  extern.  [The  rect.  externus 
has  two  origins,  one  as  stated,  the  second  from  the  margin  of  the  spheroidal 
fissure.] 

Rectus  superior  s.  superbus  is  the  weakest;  rect.  inferior  s.  humilis:  rect. 
internets  s.  amatorius  8.  bibitorius,  the  shortest  and  thickest ;  rectus  externus 
s.  indignatorius,  antagonist  of  the  two  obliqui,  the  longest,  is  alone  provided 
by  nerv.  abducens,  the  others  by  2V.  oculo-motorius. 

c.  M.  obliquus  superior  s.  trochlearis  s.  patheticus. 

Or. :  between  m.  rectus  sup.  and  intern,  before  the  foram.  opticum,  from 
the  body  of  the  Sphenoid  bone.  Ins. :  at  the  superior  part  of  the  Sclerotica; 
four  lines  broad,  behind  muse.  rect.  super.  Figure :  elongated,  fusiform ;  the 
tendon  curves  backwards,  downwards,  and  outwards.  Position :  at  the 
superior,  internal  angle  of  the  orbits ;  the  tendon  passes  in  the  trochlea  [a 
small  cartilage,  five-sixths  of  a  small  ring]  through  a  tendinous  sheath.  It 
is  alone  provided  by  nerv.  trochlearis.  Use :  to  roll  the  globe  inwards  and 
downwards. 

d.  M.  obliquus  inferior  s.  minor. 

Or. :  os  maxilar  super.,  between  margo  infer.  orbit<B  [sometimes  from  it] 
and  canal,  lacrymal. ;  often  from  the  lacrymal  sac.  Ins. :  the  posterior  ex- 
ternal part  of  Sclerotic,  six  lines  distant  from  the  cornea,  three  from  the  optic 
nerve,  behind  the  attachment  of  rectus  externus.  Pos. :  flat  under  the  globe 
of  the  eye  (externally,  above  and  behind)  between  the  floor  of  the  orbit  and 
TO.  rectus  inferior,  enveloped  in  fat.  Use:  to  roll  the  bulbus  outwards  and 
upwards.  Both  muse,  obliqui  draw  the  globe  forwards  [?] . 

496.         B.  The  Globe  of  the  Eye,  Bulbus  oculi, 

an  oblong  globe  formed  of  three  circular  membranous  layers  lying 
over  one  another,  which  are  filled  with  a  transparent  refracting  ap- 
paratus, being  surrounded  by  the  capsule  of  the  eye  arid  an  elastic 
cushion  of  adipose  tissue  in  the  anterior  parts  of  the  orbits,  and 
projecting  outwards  at  the  external  border  of  the  basis  beyond  it. 
Its  longitudinal  diameter  is  about  one  line  longer  (eleven  lines)  than 
the  transverse,  as  the  anterior  segment  of  the  globe  formed  by  the 
cornea  projects  before  that  composed  of  the  Sclerotica. 

Capsula  bulbi  oculi  (Bonnet  and  Ferrall), 

a  strong,  fibrous  membrane,  firmly  applied  behind  to  the  globe,  and 
passing,  becoming  thinner  in  its  course,  into  the  fibrous  sheath  of 
the  Optic  nerve,  before  into  the  Perichondrium  of  the  tarsi  of  both 
eyelids.  All  the  muscles  of  the  globe  lie  behind  and  perforate  it 


264  SPECIAL  ANATOMY. 

with  their  anterior  extremities,  in  order  to  attach  themselves  to  the 
Sclerotica  ;  so  that,  in  consequence  of  the  thickness  and  strength 
of  the  capsule,  each  passes  away,  as  it  were,  over  a  trochlea.' 

a.  The  most  external  of  the  coats  of  the  eye.  They  determine 
the  shape  of  the  organ.  They  are  the  stiff  Sclerotica  and  the 
transparent  cornea. 

497.      1.  Sclerotica  (s.  tunica  albuginea  s.  cornea  opaca), 
the  white  coat. 

a  strong,  opaque  membrane,  forms  a  segment  of  a  sphere,  the  anterior  sixth 
of  which  is  represented  by  the  transparent  cornea.  It  consists  of  short  fibrous 
fasciculi  interlacing  with  each  other  in  every  direction,  is  bluish,  brilliant 
(inwardly  brown),  provided  with  few  vessels,  and  not  at  all  with  nerves.  [?] 
Rigid,  and  not  extensible,  it  is  thinnest  anteriorly  in  the  neighbourhood  of  the 
Cornea,  behind,  where  a  foramen  for  the  Optic  nerve  perforates  it,  thickest. 
The  foramen  for  the  optic  nerve  lies  rather  internally  to  the  axis  of  the  globe. 
The  external  surface  of  the  Sclerotica  is  covered  before  by  the  conjunctiva 
connected  with  it  by  loose  uniting  tissue,  and  by  the  tendons  of  the  mus- 
cles of  the  globe.  The  internal  surface  is  wrinkled,  brown,  and  connected 
by  delicate  uniting  tissue  and  the  obliquely  passing  ciliary  vessels  with  the 
tun.  Choroidea.  The  ciliary  nerves  pass  from  behind  forwards  between  the 
two  coats. 

The  anterior  border  is  circular,  bevelled  off  on  the  internal  surface  ob- 
liquely backwards  (sulcus  Sclerotica),  for  the  reception  of  the  corresponding 
bevelled  border  of  the  Cornea.    Both  are  firmly  united  together.     Between 
them  and  the  ligam.  ciliare,  which  is  here,  also,  attached,  we  find  (in  animals) 
sinus  circularis  venosus  iridis  s.  canalis  Fontana,  a  very  narrow  circular 
canal  which  receives  the  veins  and  the  blood  of  the  iris,  which  is  driven 
out  from  these  during  enlargement  of  the  pupil,  and  is  said  to  give  off  vv. 
ciliares  anticce  ;  but  in  Man  it  is  placed  in  the  substance  of  the  Cornea  (as 
canalis  Schlemmit). 

The  Sclerotica  is  to  be  considered  as  a  continuation  of  the  dura  Mater  upon 
the  Optic  nerve  ;  [?]  the  pia  mater  and  arachnoidea  do  not  pass  into  the  eye. 
At  the  foramen  for  n.  options  a  lamina  cribrosa  was  formerly  described,  that 
is,  a  perforated  plate  which  apparently  arises  from  the  manner  in  which  the 
neurilemma  leaves  the  fasciculi  of  the  n.  Options  at  this  place. 

Vessels :  a  few  arteries  from  artt.  ciliares  ;  Veins  more  numerous,  in  con- 
nexion with  the  canals  of  the  Cornea ;  Lymphatics  are  probably  present. 
Nerves  not  yet  demonstrated. 

498.     2.  (  Tunica)  Cornea,  the  transparent  Cornea, 

is  a  thick,  transparent,  strong,  but  elastic  membrane,  forming  the  segment  of 
a  smaller  (also  more  convex)  sphere  than  the  Sclerotic,  and  the  anterior  part 
of  the  bulbus.  Its  anterior  convex  surface  is  covered  by  Epithelium,  a  conti- 


THE  SENSES.  265 

nuation  of  that  of  the  conjunctiva  (this  is  the  firmly  applied  conjunctiva  cor- 
nea) ;  the  posterior  concave  surface  forms  the  anterior  wall  of  the  anterior 
chamber  of  the  eye  :  its  posterior  border,  bevelled  obliquely  on  the  external 
surface,  is  extremely  firmly  united  with  the  Sclerotica.  (According  to  Va- 
lentin, both  membranes  grasp  one  another  by  indentations  of  looped  and  re- 
flected fibres.) 
The  cornea  consists  of  four  layers : 

a.  Epithelium  on  the  anterior  surface,  forms  after  death  a  slimy  covering, 
which  makes  the  cornea  appear  opaque  (conjunctiva  cornea). 

b.  The  proper  cornea  is  laminated,  and  consists  of  flat  cell  fibres  which  in- 
terlace in  all  directions,  becoming  in  boiling  water  a  white  jelly  and  dissolved. 

c.  The  membrana  Demoursii  s.  Descemetii,  a  firm  cartilaginous,  colourless, 
and  transparent  thin  membrane,  which  remains  unchanged  in  boiling  water; 
does  not  pass  over  upon  the  Iris,  but  passes  over  to  its  external  border  and 
terminates  between  sclerotica  and  lig.  ciliare  with  a  sharp  border. 

d.  The  pavement  Epithelium  on  the  posterior  surface  of  the  Demoursian 
membrane  reaches  only  as  far  as  the  external  border  of  the  Iris,  and  looks 
into  the  anterior  chamber  of  the  eye  (this  is  the  so-called  membr.  humoris 
aquei).   The  cornea  is  nourished  mediately  only,  by  the  aqueous  humour  with 
which  it  is  saturated.    In  the  foetus  a  capillary  rete  is  found  under  the  ante- 
rior epithelium,  the  branches  of  which  come  from  the  vessels  of  the  conjunc- 
tiva scleroticce;  in  the  adult  the 

Canalis  Schlemmii  (see  before,  $  497),  near  to  the  border  of  the  cornea,  is 
said  to  be  a  venous  sinus,  but  it  receives  no  branches  from  the  cornea. 
The  layers,  a,  c,  and  d,  possess  no  vessels  ;  in  the  inflammatory  condition 
of  the  eye  such  may  be  regarded  as  but  only  newly  formed.     Nerves  :  (disco- 
vered by  Schlemm  in  the  eyes  of  animals)  arise  from  the  ciliary  nerves  on  the 
sclerotica,  and  are  lost  at  the  border  of  the  cornea; — Pappenheim  has  followed 
them  between  the  lamellae. 

The  cornea  is  more  convex  and  thicker  in  the  embryo  and  the  newly  born 
than  in  the  adult.  Impinging  rays  of  light  passing  through  it  become  refracted 
in  a  converging  direction. 

Weber  has  classed  the  cornea  with  the  Epidermic  formations.  According 
to  Arnold  its  substance  passes  immediately  into  that  of  the  (fibrous)  Sclero- 
tica, and  it  bears  all  the  characters  of  a  serous  membrane,  as:  transparency, 
secretion  of  serum,  vascular  canals,  formation  of  bloodvessels,  regeneration; 
the  laminated  structure  is  only  an  artificial  production. 

Arnold  admits  of  a  second  layer  between  sclerotica  and  choroidea  ;  this  is 
the 

Arachnoidea  oculi,  which  is  said  to  form  a  closed  serous  sac,  and  has 
been  already  observed  by  Zinn,  Wardrop,  and  others,  the  external  por- 
tion of  which  has  been  designated  lamina  fusca  sclerotica,  the  internal 
membr.  suprachoroidea.  Cases  of  a  morbid  collection  of  fluid  (by  Riolan, 
Weller,  Scarpa)  are  said  to  support  this  acceptation.  According  to 


266  SPECIAL  ANATOMY. 

Henle  it  does  not  exist ;  but  there  is  only  to  be  found  in  this  situation  a 
loose,  delicate,  uniting  tissue  with  pigment  cells. 

b.  The  central,  vascular,  and  coloured  layer  of  the  coats  of  the 
eye. 

499.  3.  Choroidea  s.  tunica  vasculosa, 

a  thin,  very  vascular  tunic  of  the  same  extent  as  the  sclerotica,  to  the  internal 
surface  of  which  it  is  attached  by  a  delicate,  brown,  uniting  tissue  (see  Arach. 
oculi).  Both  surfaces,  but  especially  the  internal,  on  which  the  Eetina  lies, 
are  covered  by  a  deposit  of  black  pigment  which  consists  of  mosaic-like, 
angular,  or  roundish  cells,  and  is  provided  with  innumerable  convoluted  longi- 
tudinal striae  which  correspond  to  vessels.  What  has  been  described  as  lamina 
fusca  scleroticce,  is  probably  identical  with  the  pigment  deposit  on  the  external 
surface  of  the  choroid.  Behind,  this  membrane  is  perforated  by  a  circular 
foramen  for  the  passage  of  the  optic  nerve.  The  choroid  has  been  artificially 
divided  into  an  external  (venous)  layer,  and  an  internal  (arterial,  membran. 
Ruyschiana) ;  of  which  we  may  assume  the  former  to  form  the  ligam.  ciliare, 
the  latter  the  corpus  ciliare.  Vessels  :  artt.  ciliares  post,  upon  the  internal 
surface  ;  vasa  vorticosa  (veins)  upon  the  external  surface,  pass  into  vv.  ciliar. 
postt.  Nerves ;  a  few  ramify  in  it,  most  pass  through  it.  (Pappenheim.) 

a.  Ligamentum  ciliare  s.  orbicularis  ciliaris,  the  ciliary  ligament,  a  flat,  gray 
and  delicate  circle,  from  a  line  to  a  line  and  a  half  broad,  the  anterior,  smaller 
and  thicker  border  of  which  abuts  on  the  point  of  junction  of  the  cornea  and 
sclerotica  and  unites  with  the  external  border  of  the  iris,  whilst  the  posterior, 
thinner,  and  larger  border  meets  the  corpus  ciliare,  and  receives  the  ciliary 
nerves  which  divide  in  the  ciliary  ligament,  going  through  it  (Arnold)  or  rami- 
fying in  it  (Pappenheim).     Its  external  surface  lies  loosely  on  the  anterior  part 
of  the  interior  of  the  sclerotica,     A  vascular  rete  with  large  meshes  in  it,  is 
connected  behind  with  that  of  the  choroid,  and  passes  anteriorly  into  the  iris. 

b.  Corpus  ciliare,  the  ciliary  body,  the  internal  lamina  of  the  anterior  bor- 
der of  the  choroid,  reaches  farther  backwards  than  a,  is  sharply  bounded  by  a 
toothed  edge  from  the  proper  choroid,  but  which  belongs  to  the  zonula  Zinnii, 
turns  up  from  the  posterior  body  of  the  lig.  cilia  re  inwards  to  the  border  of  the 
lens,  and  forms  a  flat  circle  which  consists  of  the 

Processus  ciliares, — seventy  to  eighty  short  folds.  These  become  larger 
from  behind  forwards,  and  they  converge  ;  in  the  intervals  between  them  cor- 
responding folds  of  the  zonula  Zinnii  are  placed,  whereby  both  are  firmly 
united  with  one  another,  and  the  ciliary  body  with  the  capsule  of  the  lens ; 
deprived  of  the  pigment  layer  in  their  depressions,  they  appear  white.  It  is 
said  that  a  circle  of  (muscular)  fibres  extends  from  their  free  circumference  as 
far  as  the  capsule  of  the  lens ;  this  is 

Amman's  orbiculus  capsulo- ciliaris,  but  which  belongs  to  the  zonula  Zinnii. 
A  proper  membrana  pigmenti  is  even  admitted  by  some,  which  separates  the 
pigment  layer  on  the  posterior  surface  of  the  choroid  from  the  Retina,  is  re- 


THE  SENSES.  267 

fleeted  at  the  capsule  of  the  lens  over  and  upon  the  posterior  surface  of  the 
iris,  to  terminate  at  the  margin  of  the  pupil. 

The  pigment  is  so  much  the  darker,  the  farther  it  lies  internally ;  it  is  some- 
times entirely  wanting  (in  Albinos);  it  sometimes  presents  deposits  of  salts 
(the  so-called  ossifications).  In  ruminants,  also  the  dog  and  cat,  remarkably 
brilliant,  it  is  called  tapetum. 

500.  4.  The  Iris, 

a  thin  disc-shaped  membrane,  becoming  thicker  from  without  inwards,  con- 
sisting of  contractile  tissue,  forms  a  vertical  septum,  perforated  by  a  foramen, 
between  the  anterior  and  posterior  chambers  of  the  eye.  The  foramen  (pupilla) 
is  not  placed  quite  in  the  centre,  but  rather  to  the  inner  side,  is  bounded  by 
the  internal  or  free  border  of  the  Iris,  is  dilated  or  contracted  according  as  the 
last  contracts  or  relaxes,  and  is  closed  in  the  fetus  by  the  membrana  pupillaris. 
The  external,  larger  (ciliary)  border  of  the  Iris  is  loosely  attached  to  the  lig. 
ciliare  which  on  the  anterior  surface,  and  to  the  proc.  ciliares,  which  on  the 
posterior  surface  project  rather  over  it.  The  anterior  surface  of  the  Iris  is 
flat,  speckled  (blue,  brown,  &c.),  striated,  and  forms  the  posterior  wall  of  the 
anterior  chamber  of  the  eye.  Towards  the  pupillary  margin  the  colour  is 
deeper  than  in  the  remaining  two-thirds;  we  therefore  distinguish  a  zona 
iridis  minor  and  major.  The  striae  pass  from  the  external  towards  the  inner 
margin,  converge  and  cross  each  other ;  they  are  in  the  contracted  pupil 
straight,  in  the  dilated  wavy,  like  the  vessels  through  which  they  arise. 

The  posterior  surface  is  covered  with  a  thick  layer  of  black  pigment,  on  the 
ciliary  border  by  the  proc.  ciliares,  and  folded  ;  denuded  of  pigment,  it  is  white 
and  smooth,  like  the  Choroid,  which,  besides,  is  far  thinner  than  the  Iris. 

Structure.  The  Iris  probably  consists  of  contractile  uniting  tissue,  accord- 
ing to  the  older,  now  also  the  opinion  supported  by  Valentin,  of  simple  mus- 
cular fibres,  which  pass  like  a  sphincter  on  the  pupillary  margin.  (In  the  ox 
there  are  distinct  circular  fibres.) 

Vessels  and  Nerves:  Art.  ciliares  anticce  andpostica  longos  (see  art.  ophthal.) 
form  a  circulus  arteriosus  iridis  major  on  the  ciliary  border,  from  which  arises 
a  circ.  art.  irid.  minor,  on  the  pupillary  margin. 

Veins :  like  the  arteries ;  some  open  into  the  canalis  Fontance. 

Nerves:  N.  ciliares,  from  ganglion  ciliare,  very  numerous,  pass  through 
lig.  ciliare  into  the  Iris. 

There  was  formerly  distinguished  an  anterior  lamina,  the  proper  Iris,  and 
a  posterior,  uvea. 

c.  The  third  layer  of  the  coats  of  the  globe  of  the  eye. 

501.  The  Retina  s.  tunica  nervea  the  nervous  coat, 

a  soft,  yellowish  white  membrane,  which  is  placed  concentrically  on  the 
internal  surface  of  the  Ckoroidea,  covered  with  pigment,  consists  of  several 
layers,  the  most  essential  of  which  is  a  smooth  expansion  of  the  Optic  nerve. 


268  SPECIAL  ANATOMY. 

Its  internal  surface  is  applied  loosely  to  the  vitreous  body;  its  anterior 
extremity  reaches  as  far  as  the  posterior  border  of  corpus  ciliare  (according  to 
the  older  view  as  far  as  the  lens,  before  or  behind  the  zonula  Zinnii).  At  the 
posterior  extremity,  where  the  rather  projecting  optic  nerve  enters  (medullary 
elevation),  it  presents  in  the  axis  of  the  eye,  that  is  to  say,  on  the  external  cir- 
cumference of  the  optic  nerve,  a  transparent  spot  (probably  not  perforated), 
the  so-called 

Foramen  centrale  retinas,  hidden  behind  a  yellow  transverse  fold,  macula 
lutea.  This  last  is  found  in  man  (and  apes)  only,  and  even  here  but  for  a  time 
after  birth.  Its  object  is  unknown. 

Structure : 

1.  The  external  layer  of  the  Retina,  which  is  connected  with  Choroid,  and 
is  described  as  Tunica  Jacobi,  consists  of  the  so-called  rod-shaped  corpuscles, 
that  is  to  say,  closed  cylinders,  which  are  soft,  flexible,  easily  torn,  filled  with 
an  oily  material,  and  only  loosely  joined  with  one  another. 

2.  The  proper  nervous  layer  arises  from  the  manner  in  which  the  optic 
nerve  sends  out  nerve  tubules  in  bundles  from  its  place  of  entrance  in  all 
directions,  and  forms  long  meshed  plexus.    Whether  the  nerve  fibres  termi- 
nate freely,  or  are  reflected  in  loops  (Valentin),  is  yet  uncertain.    Likewise, 
whether  a  proper  (ganglion)  globular  layer  exists  on  the  internal  nervous 
layer. 

3.  This  lies  immediately  within  a  dark  granular  layer,  in  which  the  vessels 
pass,  and  which  towards  the  vitreous  body  is  bounded  by  a  kind  of  large- 
celled  epithelium  (vascular  layer  of  the  Retina).    This  last  passes  over  the 
processus  ciliares,  and  extends  over  the  zonula  Zinnii  as  far  as  the  capsule  of 
the  lens  (whilst  the  nervous  and  cylindrical  layers  do  not  reach  the  corp.  cili- 
are), and  forms  the  so-called  ciliary  portion  of  the  Retina  (Henle).   According 
to  Bidder,  the  layer  of  cylindrical  cells  does  not  reach  to  the  zonula  ciliaris. 
His  layer  of  ganglion  globules  (continuations  of  the  gray  substance)  and  the 
stratum  nerveum  (continuation  of  the  white  substance)  reaches  as  far  as  the 
capsule  of  the  lens.    According  to  Langenbeck,  jun.,  and  Pappenheim,  a 
sinus  passes  on  the  internal  surface  in  the  anterior  border  of  the  retina,  sinus 
s.  circulus  venosus  retince. 

[Art. :  See  Angiology,  Art.  ophthal.] 

Function  of  the  Retina :  it  presents  a  susceptible  nervous  surface 
towards  the  light,  the  sensation  of  which  is  transmitted  by  the  optic 
nerve  to  the  cerebrum. 

d.  The  transparent  nucleus  of  the  eye. 
502.          1.  Humor  aqueus,  the  aqueous  humour, 

a  transparent  fluid,  as  clear  as  water,  of  spec.  grav.  1-005,  con- 
tains most  water  and  only  a  little  common  salt  and  albumen,  fills 


THE  SENSES.  269 

up  the  anterior  and  posterior  chambers  of  the  eye,  and  is  probably 
secreted  by  the  Iris  and  the  corpus  ciliare  (according  to  others  by 
the  vitreous  body,  &c.). 

a.  Camera  oculi  anterior  is  the  space  between  cornea  and  Iris,  measures  in 
the  longest  diameter  from  before  backwards  about  one  line,  is  at  its  circum- 
ference encompassed  by  the  anterior  extremity  of  the  lig.  ciliare,  and  stands, 
through  the  pupillary  aperture,  in  connexion  with  : 

b.  Camera  oculi  posterior,  that  is,  the  small  (one-third  of  a  line)  space  be- 
tween the  posterior  wall  of  the  Iris  and  the  anterior  surface  of  the  capsule  of 
the  lens.     The  two  chambers  contain  about  five  grains  of  fluid.     The  ante- 
rior chamber  is,  in  the  foetus,  shut  out  from  the  posterior  by  the  pupillary 
membrane.    An  aqueous  membrane  which  lines  the  two  chambers  as  a  closed 
sac,  for  which  the  membr.  Descemetii  is  said  to  pass,  is  not  to  be  found. 

503.         2.  Lens  crystattina,  the  crystalline  lens, 

a  round,  biconvex,  colourless,  transparent  body,  is  situated,  narrowly  enclosed 
by  its  capsule,  behind  the  pupUla,  at  the  boundary  of  the  anterior  fourth  of  the 
globe,  and  its  axis  in  the  axis  of  the  pupil. 

Its  anterior  surface  is  flatter,  one  line  and  a  half  distant  from  the  cornea  ; 
the  posterior  more  convex,  four  lines  distant  from  the  fundus  of  the  eye.  Its 
margin  is  encompassed  by  the  folds  of  the  zonula  Zinnii,  and  encircled  by 
canalis  Petiti. 

Structure.  The  substance  of  the  lens  contained  in  the  capsule  becomes 
thicker  from  without  inwards.  The  anterior  portion,  almost  a  thin  fluid,  the 
so-called  liquor  Morgagni,  contains  cells,  like  the  gelatinous  portion  found 
behind  it,  with  a  very  delicate  membrane,  which,  when  their  water  evapo- 
rates, become  dark  and  granular.  Upon  the  cellular  layer  narrow,  straight 
fibres  follow,  which  form  layers,  and  lie  close  upon  one  another,  like  the 
scales  of  an  onion,  inwards  towards  the  middle  thickened  into  a  nucleus  (of 
a  gummy  consistency).  Each  lamina  consists  on  the  anterior  surface  of  the 
lens  of  three,  on  the  posterior  of  four  triangles,  between  which  a  space  in  the 
form  of  a  A  or  )=(  remains,  to  which  the  fibres  converge  inwards,  so  that  the 
lens  breaks  up  into  three  to  four  (or  more)  wedge-shaped  pieces  by  the  action 
of  an  acid,  boiling  water,  or  even  merely  by  heat. 

The  substance  of  the  lens  contains,  more  than  the  half,  water,  and  much 
albumen,  (Globulin  according  to  Berzelius;  Casein,  Fr.  Simon.);  it  becomes 
cloudy  after  death  (whether  by  coagulation  ?),  and  coagulates  in  sulphuric  and 
phosphoric  acids,  which  last  does  not  make  it  opaque. 

The  capsule  of  the  lens,  capsula  lentis,  a  simple  membrane,  clear  as  water 
(under  the  microscope  a  faint  yellow),  in  adults  non-vascular,  is  smooth, 
strong,  stiff,  and  distinctly  thicker  on  the  anterior  wall  than  on  the  posterior. 
Its  anterior  wall  looks  freely  into  the  posterior  chamber  of  the  eye,  lies  quite 
open  when  the  pupil  is  widely  dilated,  and  is  firmly  connected  at  the  margin 
with  zonula  Zinnii;  its  posterior  wall  lies  in  the  fossa-hyaloidea  of  the  vitre- 
ous body. 


270  SPECIAL  ANATOMY. 

It  is  rendered  neither  cloudy  nor  soluble  either  by  boiling  water,  or  by  alco- 
hol and  acids.  Of  nerves  it  also  possesses,  like  the  lens,  a  few ;  and  the  ves- 
sels which  it  shows  in  a  morbid  condition  are  only  developed  in  an  abnormal 
manner.  However,  Walter  has  injected  vessels  on  the  posterior  wall  of  the 
capsule. 

The  very  vascular  capsule  of  the  lens  in  the  Embryo  (membrana  pupillaris, 
and  capsulo-pupillaris}  is  a  closed,  delicate  membrane,  formed  of  a  capillary 
rete,  which  at  the  commencement  closely  surrounds  the  lens  and  its  non-vas- 
cular capsule ;  but  later,  when  the  eye  grows,  it  becomes  smaller  in  propor- 
tion to  the  lens,  and  is  applied  to  the  Iris  with  its  internal  border ;  the  ante- 
rior portion  of  the  sac  is  removed  from  the  lens  and  capsule,  and  now  consists 
of  two  halves,  namely,  the  piece  which  reaches  from  the  border  of  the  lens  to 
the  pupillary  border  of  the  Iris  (membr.  capsulo-pupillaris,  J.  Miiller),  and  the 
piece  which  closes  the  pupil  vertically  (membr.  pupillaris,  Wachendorf). 
From  the  seventh  month  the  vessels  are  obliterated  (on  the  pupillary  mem- 
brane from  the  centre  towards  the  circumference),  the  membranes  themselves 
disappear,  and  the  humor  aqueus  is  produced ;  in  the  fossa  hyaloidea  a  few 
vessels  appear  to  continue  in  existence. 

504,  3.   Corpus  vitreum,  the  vitreous  humour, 

a  globular,  completely  transparent  body,  which  consists  of  a  viscous  fluid  and 
a  membrane  (not  anatomically  demonstrable),  filling  up  the  posterior  three- 
fourths  of  the  globe  of  the  eye,  is  surrounded  by  the  Retina,  and  receives  on 
its  anterior  surface,  in  a  depression  (fossa  hyaloidea},  the  posterior  surface  of 
the  lens.  At  the  posterior  boundary  we  find  in  the  foetus  an  infundibular- 
shaped  fossa,  area  Martegiani,  which  arises  from  the  Art .  capsularis,  passing 
in  its  canal,  drawing  upwards  the  vitreous  body  during  the  obliteration  of  its 
branches  (or  only  arises  after  death,  Arnold). 

Humor  vitreus,  the  vitreous  humour,  is  colourless,  and  behaves,  chemically, 
exactly  like  the  humor  aqueus.  It  is  (probably)  placed  in  cells  of  the  vitreous 
membrane,  which,  by  punctures,  are  individually  emptied,  but  nevertheless, 
perhaps,  communicate  with  each  other.  In  the  Embryo  it  is  nourished  by 
numerous  vessels,  of  which,  at  a  later  period,  the  principal  trunk  only,  pass- 
ing to  the  fossa  hyaloidea,  art.  capsularis,  remains  behind. 

Membrana  hyaloidea,  the  vitreous  [or  hyaloid]  membrane,  is  only  visible 
under  the  microscope  ;  it  is  said  to  form  the  cells  and  the  envelope  of  the 
whole  vitreous  body.  This  envelope  is  said  to  divide  at  the  anterior  boun- 
dary of  the  vitreous  body  into  two  lamina,  one  of  which  passes  behind  the 
lens,  and  the  other  on  its  anterior  surface,  so  that  between  the  two  the 

Cdnalis  Petiti,  a  triangular,  circular,  and  closed  canal,  is  formed,  which 
surrounds  the  border  of  the  capsule  of  the  lens  like  a  projecting  fold,  and  pro- 
bably contains  fluid. 

The  anterior  lamina,  strengthened  by  a  fibrous  layer  of  corpus  ciliare  (on 
its  posterior  surface),  forms  the 

Zonula  Zinnii  a.  corona  ciliaris  (whether  an  independent  structure  or  not  is 


THE  SENSES.  271 

still  doubtful).  It  lies  like  a  circlet  of  folds  before  the  vitreous  body,  around 
the  border  of  the  lens,  behind  the  corpus  ciliare,  and  presents  alternating 
black  and  clear  rays.  The  rays  are  longer  than  the  proc.  ciliares  of  the  cho- 
roid,  and  form  depressions  and  folds  which  correspond  to  those  of  the  last. 
Its  posterior  border  is  undulating  and  indented  (ora  serrata),  and  impinges 
upon  the  anterior  boundary  of  the  Retina  ;  its  anterior  border  is  firmly  con- 
nected to  the  border  of  the  capsule  of  the  lens  (upon  the  anterior  surface). 
The  corona  ciliaris  in  the  foetus  is  supplied  plentifully  with  blood-vessels, 
which  anastomose  with  those  of  the  very  vascular  capsule  and  Choroidea  ;  but 
in  the  adult,  like  the  hyaloid  membrane,  it  is  non-vascular. 

505.  II.  The  organ  of  Hearing.     Organon  auditus. 

The  ear,  auris,  consists  of  three  parts.  These  are :  The  ex- 
ternal, that  is,  the  auricular  cartilage  and  the  external  auditory 
meatus.  The  central,  that  is,  the  tympanic  cavity  and  the  Eus- 
tachian  tube.  The  internal,  that  is,  the  Labyrinth. 

A.  The  external  part. 

506.  1.  The  external  ear,  auriculus,  the  ear,  an  oval,  elastic, 
cartilaginous  plate,  many  times  curved,  situated  on,  and  firmly 
attached  by  ligaments  to,  the  lateral  parietes  of  the  head  at  an 
angle  of  from  25°  to  30°,  covered  by  the  external  integument.    On 
its  outer  surface  the  following  parts  may  be  observed : 

a.  Concha  auris,  a  hollow,  the  shape  of  a  muscle  shell,  at  the  anterior  and 
inferior  part  of  which  the  external  auditory  canal  commences,  is  bounded  an- 
teriorly by 

1.  Tragus,  the  anterior  auricular  valve,  that  is,  a  rounded,  four-sided 
plate,  internally  beset  with  hairs,  which  can  close  the  external  auditory 
meatus  in  front. 

2.  Antitragus,  a  small  triangular  projection  at  the  termination  of  the 
anthelix.     It  lies  rather  deeper,  opposite  to  the  tragus,  and  between  the 
two  we  find : 

incisura  intertragica,  a  deeper  and  rounded  excavation,  above  the 
lobule  of  the  auricle.     Above  and  behind,  the  concha  is  bounded  by : 

3.  Anthelix,  that  is.  a  curvilinear  elevation,  which  commences  above 
the  antitragus,  passes  upwards  and  forwards,  and  terminates  with  two 
crura  (a  sharp  inferior  and  a  blunt  superior),  between  which  is  situated  a 
shallow,  triangular  fossa,  fossa  innominata. 

b.  Helix,  that  is,  the  elevation  which  commences  in  the  auditory  concha, 
separates  it  into  a  superior  and  inferior  portion,  then,  parallel  with  the  anlhe- 
lix,  forms  the  external  anterior  reflected  border  of  the  auricle,  and  ceases  at 
the  auricular  lobule. 

Between  helix  and  anthelix  an  oblong  fossa,  fossa  navicularis  s.  scaphais 


272  SPECIAL  ANATOMY. 

situated,  extending  from  the  superior  extremity  of  the  auricle,  almost  as  far 
as  the  lobule. 

The  cartilage  of  the  ear  is  elastic  and  flexible,  covered  with 
Perichondrium.  The  external  integument  which,  particularly  on 
the  concha,  is  applied  closely  to  it,  is  delicate  and  transparent, 
beset  with  folliculi  sebacei,  particularly  in  the  concha  and  fossa 
innominata^  with  little  hairs  (tragi)  upon  the  tragus.  On  the 
border  of  the  helix  it  is  applied  more  loosely,  and  forms  at  the 
inferior  extremity  a  fold,  the  lobule  of  the  auricle  (lobulus  auri- 
cula,) between  the  layers  of  which  we  find  a  deposit  of  adipose 
tissue. 

Ligaments : 

a.  Lig.  auriculas  posterius  is  thick,  and  extends  from  the  posterior  parts  of 
the  concha  to  the  superior  ofproc.  mastoideus. 

b.  Lig.  anterius  B.  Valsalvce,  triangular,  broad,  and  strong,  arises  from  a 
nodule  on  the  helix,  close  above  tragus,  and  even  from  this,  and  attaches  itself 
to  the  root  ofproc.  zygomat.  (oss.  tempor.) 

Muscles.  (For  those  moving  the  whole  auricle,  see  Myology.)  They 
should  move  the  separate  parts  of  the  ear,  but  they  are  rudimentary;  in 
savages,  besides,  not  more  strongly  developed.  The  four  first  lie  on  the  ex- 
ternal surface  of  the  auricle. 

a.  M.  helicis  major,  narrow,  about  half  an  inch  long,  thin,  at  the  arched 
superior  and  anterior  part  of  the  Helix,  fibres  vertical. 

b.  M.  helicis  minor,  very  small,  at  the  arched  inferior  and  posterior  part. 

c.  Tragicus,  three-cornered,  tolerably  thick,  with  vertical  fibres ;  upon  the 
tragus. 

d.  Antitragicus,  narrow,  short;  passes  from  the  antitragus  to  the  anthelix. 

e.  Transversus  auriculas,  transverse  on  the  posterior  surface  of  the  ear,  from 
the  convexity  of  the  concha  to  the  external  part  of  the  anthelix. 

f.  Dilatator  concha  (Theile),  from  the  anterior  surface  of  the  cartilaginous 
meatus  audit,  on  the  anterior  inferior  part  of  the  tragus.     Use  :  to  draw  the 
tragus  forwards,  and  thus  dilate  the  concha. 

g.  Obliquus  auricula  (Arnold),  upon  the  internal  surface  of  the  ear,  between 
the  elevations  of  fossa  innominata  and  the  concha. 

Vessels  and  nerves.  Arteries :  art .  auricularis  posterior  ;  a  branch  perfo- 
rates the  helix,'  and  enters  into  the  concha  ;  the  rest  curve  round  the  edge  of 
the  former.  Art.  auriculares  anter.  from  temporalis.  Veins :  they  open  into 
V.facialis  posterior. 

Nerves :  nn.  auriculares  anterior,  superior,  magnus  [to  the  skin  (sensitive)] ; 
posterior  [to  the  muscles]  ;  and  a  ramus  nerv.  vagi. 

507.     2.  The  external  auditory  canal,  meatus  auditorius 

externus, 
a  semi-cartilaginous,  semi-osseous  canal,  one  inch  long,  is  elliptical 


THE  SENSES.  273 

in  the  transverse  section,  and  passes  from  the  base  of  the  auditory 
concha  horizontally  to  the  membrana  tympani,  that  is,  from  without 
inwards  and  from  behind  forwards.  Close  to  the  entrance  it  makes 
a  bend,  the  curve  upwards  (whenever  we  wish  to  see  to  the  end  of 
the  auditory  passage,  the  centre  of  the  auricle  must  be  drawn  up- 
wards and  backwards).  The  entrance  is  oval  beset  with  hairs, 
bounded  before  by  tragus,  behind  by  the  crescentic  crista  of  the 
concha.  The  internal  opening  circular,  directed  obliquely  from 
above  downwards  and  from  without  inwards,  and  closed  by  the 
tympanic  membrane.  The  narrowest  place  is  found  at  the  bend, 
the  widest  at  the  junction  of  the  cartilaginous  and  osseous  parts. 
Superior  wall,  ten  lines,  inferior,  thirteen,  posterior,  ten  and  a  half, 
anterior,  twelve  and  one  third  long. 

a.  The  osseous  portion  (seven  to  eight  lines  long)  lies  on  the  basis  oss. 
petrosi,  is  in' children  made  up  by  the  annulus  tympani,  of  which  a  groove 
remains  behind  (sulcus  tympani),  and  which  is  interrupted  at  the  superior 
boundary. 

b.  The  cartilaginous  portion  (five  lines  long)  is  attached  by  fibrous  uniting 
tissue  with  the  toothed  border  of  the  osseous  portion,  forming,  besides,  the 
superior  wall  which  is  attached  to  the  proc.  zygomaticus.    Its  inferior  longer 
wall  is  properly   a  continuation  of  the  tragus,  from  which,  by  incomplete 
fissures    (incisura  Santorini),  two  C-shaped  pieces  are  separated  (like  the 
trachea),  which  are  approximated  by  interposed  muscular  fibres.     The  poste- 
rior wall  is  connected  with  the  Concha. 

The  external  integument,  which  is  continued  from  the  external  ear  upon  the 
interior  of  the  auditory  passage,  is  always  more  delicate,  proceeding  inwards, 
is  from  the  commencement  beset  with  stiff,  then  with  fine  hairs  and  cerumin- 
ous  glands  (gl.  ceruminosae),  and  forms  internally  a  closed  cylinder,  since  it 
terminates  upon  the  tympanic  membrane.  The  glandules  are  numerous, 
especially  in  the  centre  (some  thousands  upon  a  square  line.) 

The  cerumen  is  very  bitter,  partly  soluble  in  water,  containing  a  yellow  oil, 
albumen,  and  salts  of  lactic  acid.  It  becomes  thickened  by  the  evaporation 
of  its  watery  elements. 

Vessels:  branches  of  Art.  auricular,  poster,  and  prof  undo. 

Nerves :  branches  ofauricul.  anter.  from  ram.  3  trigemini  and  auricul.  n. 
vagi. 

508.     3.  The  drum  of  the  ear,  membrana  tympani, 

a  thin,  elliptical,  semi-transparent  and  elastic  membrane,  four  and 
a  half  lines  in  its  vertical  diameter,  forming  a  partition  between  the 
cavity  of  the  tympanum  and  the  external  auditory  meatus,  with  the 
inferior  wall  of  which  it  describes  an  angle  of  about  45°.  Its  exter- 
nal surface  looks  also  obliquely  outwards  and  downwards  into  the 

18 


274  SPECIAL  ANATOMY. 

auditory  passage ;  its  internal  surface  upwards  and  inwards  into  the 
cavity  of  the  tympanum,  and  presents  in  the  centre  an  elevation 
where  the  handle  of  the  Malleus  draws  it  inwards  (on  the  external 
surface  a  funnel-shaped  excavation).  Its  margin  lies  in  the  sukus 
tympani  ;  close  to  that,  at  the  superior  posterior  part  of  the  mem- 
brana  tympani,  the  short  process  of  the  malleus  presses  the  last 
outwards  (umbo) ;  at  the  posterior  extremity  of  the  horizontal 
diameter  it  is  perforated  by  the  Chorda  tympani. 

The  membrana  tympani  consists  of  three  laminaB  ;  the  external 
is  the  sack-like  extremity  of  the  skin  (cutis  or  epidermis)  of  the 
auditory  passage ;  the  internal  is  a  prolongation  of  the  thin  mucous 
membrane  of  the  tympanic  cavity ;  the  central  the  proper  tympanic 
membrane,  is  very  strong,  fi  brous  (according  to  Ev.  Home  muscular), 
its  fibres  converge  from  the  circumference  towards  the  centre.  The 
vessels  appear  to  belong  exclusively  to  the  internal  lamina.  They 
form  a  close  rete,  circul.  vasor.  major  and  minor  (as  in  the  Iris). 

Art.  tympanica  superior  (from  stylomastoid,  s.  auricular,  poster.}  and  inferior 
(from  maxill.  interna  or  externa). 

Nerves:  auricul.  anterior  (trigemini.) 

The  membrana  tympani  is  strained  and  vibrates  feebly  under 
strong,  but  is  relaxed  and  vibrates  strongly  under  feeble  impres- 
sions produced  by  the  undulations  of  sound. 

B.  The  central  part  of  the  Ear. 

509.     1.  The  cavity  of  the  tympanum,  tympanum,  cavitas 
tympani, 

an  irregular,  oblong,  (four  and  a  half  lines)  narrow  (two  lines)  ca- 
vity, situated  at  the  anterior  part  of  the  basis  oss.  petrosi,  between 
the  external  auditory  canal  and  the  labyrinth.  Anteriorly  it  is  in 
connexion  by  the  tuba  Eustachii  with  the  Pharynx,  behind  and 
above,  where  it  is  more  spacious,  with  the  cells  ofproc.  Mastoideus. 
Its  external  wall  is  formed  by  the  osseous  plate  in  which  the 
memb.  tympani  is  strained  as  well  as  by  this  itself;  it  is  bounded 
before  byfissura  Glaseri  (for  chorda  tympani,  art.  tympan.  infer. 
and  lig.  mallei  anterius).  The  internal  wall  [fundus]  lies  oppo- 
site to  the  memb.  tympani^  and  presents : 

a.  Fenestra  ovalis  s.  vestibuli,  an  oblong  opening,  directed  obliquely  down- 
wards and  forwards  (H  line  long),  at  the  superior  part  of  the  internal  wall, 
lying  in  a  depression,  bounded  above  by  canal.  Fallopice,  below  by  promonto- 
rium,  is  closed  by  the  footpiece  of  the  Stapes  and  a  thin  membrane. — Under  it, 

b.  Promontorium  s.  tuber  cochleae,  an  elevation  which  corresponds  to  one 


THE  SENSES.  275 

turn  of  the  cochlea,  is  covered  with  three  grooves  opening  below  into  the  canal, 
fympanicus,  and  diverging  upwards  (for  the  anastomosis  of  Jacobson). 

c.  Eminentia  papillaris,  the  pyramid,  a  small  conical  projection  behind  the 
fenestra  ovalis  ;  a  fine  orifice  in  its  apex  leads  to  a  canal  which  passes  away 
under  canal.  Fallopia,  and  is  connected  with  it ;  this  is  canalis  stapedii. 

d.  Fenestra  rotunda,   s.  cochlea,  behind  the  promontory  in  a  depression 
(which  leads  to  the  vestibule)  is  closed  by  a  fibrous  membrana  tympani  secun- 
daria,  and  leads  into  the  Scala  tympani  of  the  Cochlea. 

At  the  anterior  boundary  the  tympanic  cavity  contracts  and  runs 
out  into  two  canals,  the  superior  of  which,  canalis  temoris  tym- 
pani (for  m.  mallei  internus)  is  separated  by  a  thin  osseous  la- 
mella from  the  inferior  canal,  that  is,  the  osseous  tuba  Eustachii, 
and  is  said  to  commence  as  a  semi-canal  (semicanal.)  with  a  wide 
open-mouthed  lamina,  proc.  cochlearis.  Above  and  behind  the 
great  opening  of  the  sinus  mastoideus  leads  into  the  cells  of  proc. 
mastoideus.  These  cells  are  filled  with  air  and  covered  with  Epi- 
thelium. The  superior  boundary  is  vaulted,  and  the  head  of  the 
malleus  and  of  incus  are  situated  in  it. 

510.     2.  The  Bones  (ossicles)  of  the  Ear,  Ossicula  auditus. 

These  are  (three  to  four)  movable  osseous  pieces,  associated  at 
angles  into  a  chain,  which  are  situated  from  without  inwards  be- 
tween the  memb.  tympani  and  the  fenestra  ovalis. 

a.  The  malleus  lies  immediately  upon  the  memb.  tympani.    We  observe  on 
it,  Head,  neck,  handle,  and  two  processes. 

1.  Head,  an  oval,  smooth  enlargement,  situated  in  the  superior  part  of  the 
tympanic  cavity,  above  the  memb.  tympani,  unites  on  its  posterior  concave 
surface  with  the  incus,  and  is  placed  upon 

2.  The  neck,  a  narrow  piece  inclined  from  before  outwards,  which  passes 
into 

3.  The  handle  (manubrium).     This  passes  off  from  the  neck  at  an  obtuse 
angle,  downwards  and  forwards,  and  terminates  with  a  roundish  point  in 
the  centre  of  the  memb.  tympani  between  the  internal  and  central  laminae. 

4.  Processus  brevis  s.  obtusus  arises  at  the  commencement  of  the  manubrium, 
on  the  outer  side,  and  presses  the  superior  part  of  the  membr.  tympani 
(umbo)  rather  outwards  in  the  ext.  auditory  meatus. 

5.  Processus  longus  (s.  folianus)  arises  from  the  anterior  part  of  the  neck, 
long  and  thin,  and  enters  into  the  Jisgura  Glaseri,  where  lig.  mallei  ante- 
rius  is  applied. 

b.  The  incus,  the  anvil,  like  a  molar  tooth,  is  situated  behind  and  below 
the  malleus.     Its  body,  that  is,  the  most  superior  thick  piece,  has  a  concave 
articular  surface  directed  forwards  for  caput  mallei.    Its  shorter,  superior  pro- 
cess passes  backwards,  and  attaches  itself  to  the  cells  of  the  proc.  mastoideus. 


276  SPECIAL  ANATOMY. 

Its  longer,  thinner  process,  passes  parallel  with  manubrium  mallei  internal  to 
and  behind  it  (chorda  tympani  between  the  two).  On  its  hooked  apex,  which 
is  bent  backwards,  we  find  the  ossiculum  lenticulare  Sylvii,  a  tubercle,  which 
is  almost  always  united  with  the  incus.  It  is  situated  freely  in  the  tympanic 
cavity.  From  its  apex  passes  inwards  to  thefenestra  ovalis. 

c.  The  Stirrup,  stapes,  horizontally,  at  a  right  angle.  Its  capitulum  unites 
with  the  ossicul.  lenticulare  ;  from  it  passes  off  inwards  an  anterior  and  a  pos- 
terior crus  (on  the  concave  surfaces  of  which,  turned  to  one  another,  we  find  a 
groove,  sulcus  stapedis),  which  become  associated  by  a  thin  plate,  the  foot 
piece  (basis  stapedis).  This  basis  passes  directly  into  the  fenestra  ovalis,  in 
which  it  moves. 

Muscles  of  the  ossicula.  So'mmerring  admits  four  muscles,  three  of  which 
belong  to  the  malleus,  one  to  the  stapes  ;  distinct  muscular  tissue  is,  however, 
only  found  in  the 

M.  tensor  tympani  s.  mallei  internus.     Or. :  from  the  superior  wall  of  the 
cartilaginous  tuba  Eustachii  and  from  the  Sphenoid  bone  (behind  foram. 
spinosum).     Course :    backwards  in  the  osseous  canal  above  the   tuba, 
enters  into  the  cavity  of  the  tympanum,  where  the  tendon  is  reflected  at, 
almost,  a  right  angle.     Ins. :  the  anterior  superior  part  oimanubr.  mallei. 
Use  :  to  draw  the  malleus  inwards,  and  stretch  the  memb.  tympani. 
To  the  ligaments  of  the  ossicula  belong  therefore,  besides  the  capsular  liga- 
ments between  malleus  and  incus,  and  between  os  lenticulare  and  stapes  : 

1.  Lig.  mallei  capiluli  s.  superius  passing  from  the  superior  wall  of  the 
tympanum  to  the  head  of  the  malleus. 

2.  Lig.  mallei  manubrii  s.  posterius  (laxator  tympani  minor) ;  passing  from 
the  internal  extremity  of  the  auditory  meatus,  upwards  and  backwards, 
to  the  manubrium. 

3.  Ligg.  processus  longi  anterius  s.  mallei  (laxator  tympani  major  s.  malleus 
externus),  passes  from  proc.  spinos.  (of  the  sphenoid  bone)  through  fissura 
Glaseri  to  the  apex  ofproc.folianus. 

4.  Lig.  processus  longi  et  brevis  incudis  come  from  the  posterior  and  exter- 
nal wall  of  the  cavity  of  the  tympanum. 

5.  Lig.  stapedis  (muse,  stapedius) ;  very  thin;  arises  inside  the  eminentia 
papillaris,  passes  out  of  it  into  the  tympanum,  passes  forwards  and  down- 
wards, and  is  attached  behind  to  the  capitulum  of  the  stapes  ;  it  is  said  to 
draw  the  stapes  backwards,  and  thereby  to  press  the  posterior  part  of  its 
basis  deeper  into  the  fenestra  ovalis,  whilst  the  anterior  part  is  raised. 
The  same  thing  happens  when  the  tensor  tympani  draws  the  head  of  the 
malleus  backwards,  and  imparts  the  movement  to  the  remaining  ossicula. 

51L        3.  The  Trumpet  of  the  Ear,  Tuba  Eustachii, 

a  straight  canal,  about  two  inches  long,  flattened  at  the  sides,  be- 
tween the  inferior  anterior  part  of  the  tympanum  and  superior 
lateral  part  of  the  pharynx,  passing  in  an  oblique  direction  from 


THE  SENSES.  277 

without  inwards,  from  above  downwards,  and  from  behind  for- 
wards. It  consists  of  an  osseous  and  a  cartilaginous  portion,  both 
of  which  are  covered  with  mucous  membrane,  which  at  the  orifi- 
cium  pharyngeum  is  thicker  than  in  the  remaining  parts,  and  at 
the  orificium  tympanicum  passes  over  into  that  of  the  tympanum. 
Both  openings  (about  two  lines  broad)  are  wider  than  the  rest  of 
the  canal  (about  one  line  broad). 

a.  The  osseous  tuba,  seven  to  eight  lines  long,  is  situated  in  the  angle  be- 
tween pars  mastoidea  and  petrosa  of  the  Temporal  bone  external  to  canal, 
caroticus,  vestibule  and  cochlea,  below  the  canalis  tensoris  tympani.     To  its 
rough  border  is  attached : — 

b.  The  cartiiagino-membranous  tuba,  the  internal  half  of  which  consists  of 
cartilage,  whilst  the  external  wall  is  formed  of  a  fibrous  coat  which  is  attached 
to  the  Sphenoid  bone.     It  lies  above  the  fossa  pterygoidea  at  the  inferior  bor- 
der of  the  ala  magna  of  the  Sphenoid  bone.     Its  oval  opening  (four  lines  high, 
two  broad)  is  tumefied,  sloped,  situated  close  behind  and  rather  above  the 
inferior  nasal  concha,  at  the  superior  part  of  the  pharynx.     The  mucous  mem- 
brane covering  it  is  looser,  very  vascular,  and  beset  with  numerous  mucous 
glands  which  are  wanting  in  the  osseous  tuba.     Through  the  tuba  the  external 
air  obtains  admission  to  the  tympanum. 

Vessels  and  nerves  for  the  central  part  of  the  organ  of  hearing.  Arteries : 
Artt.  tympanica,  stylomastoidea,  farther  branches  from  Art.  meningea  media, 
pharyngea  ascendens  and  carotis  interna  (for  tuba  Eustach.) 

Veins  :  they  open  into  the  plexus  pharyngeus  and  meningea  media. 

Nerves:  they  come  from  the  fifth,  seventh,  and  ninth  cerebral  nerves ;  they 
are :  Chorda  tympani ;  passes  from  Canalis  Fallopia  in  a  canal  peculiar  to 
itself,  then  into  the  tympanum  (between  manubr.  mallei  andproc.  long,  incudis), 
and  out  through  ihefissura  Glaseri  to  ram.  lingualis  of  the  nerv.  trigeminus  ; 
it  gives  off  no  branches  in  the  tympanum.  Anastomosis  Jacobsonii — gives  two 
filaments  to  the  membrane  in  the  region  of  ihefenest ra,  and  one  filament  to  the 
tuba  (where  by  pressure  of  the  vessels  in  sanguineous  congestion  violent  pain 
arises). 

C.  The  internal  part,  the  Labyrinth. 

512.      1.  The  osseous  labyrinth,  labyrinthus  osseus. 

1.  The  vestibule,  vestibulum,  a  small  oval  cavity  (three  lines 
high,  two  broad,  and  one  and  a  half  deep)  in  the  centre  of  the  la- 
byrinth, behind  the  Cochlea,  before  the  semicircular  canals,  situ- 
ated in  the  direction  of  the  long  axis  of  meatus  auditorius  inter- 
nus,  abutting  externally  on  the  tympanum,  above,  on  the  Canal. 
Fallopice,  below,  on  the  foramen  jugulare.  We  see  in  it — 
a.  Seven  larger  openings  : 


278  SPECIAL  ANATOMY. 

1.  Fenestra  ovalis  on  the  external  wall ;  it  is  tightly  closed  by  the  basis 
stapedis. 

2.  The  five  openings  of  the  three  semicircular  canals. 

3.  Aditus  ad  cochleam,  before  and  below  the  fenestra  ovalis. 

b.  Four  smaller  openings  : 

1.  Ostium  aquceductus  vestibuli,  on  the  posterior  wall,  internal  to  the 
common  opening  of  the  superior  and  inferior  semicircular  canals  (leads 
to  the  posterior,  the  cerebral  surface  of  the  petrous  bone). 

2.  Maculcs  cribrosce,  three  of  many  small  holes  on  the  perforated  part  of 
the  posterior  wall,  at  the  base  of  meatus  auditorius  internus,  through 
which  vessels  and  nervous  twigs  enter;  there  is  a  superior,  for  n.  sac- 
cularis  major ;  an  inferior  for  n.  ampullaris  inferior;  and  a  hemisphfe- 
rica  for  nerv.  saccularis  minor. 

c.  Depressions,  on  the  floor  of  the  Vestibule,  nearer  to  the  inner  wall : 

1.  Recessus  hemisphcericus,  anterior,  smaller  fossa,  situated  inwards  to- 
wards the  cochlea,  opposite  to  fenestra  ovalis. 

2.  Recessus  hemiellipticus,  oval,  larger  fossa,  rather  behind  and  above,  at 
the  openings  of  the  semicircular  canals.     Through  the   foramina  on 
their  base  the  nerves  pass.     The  two  are  separated  from  one  another  by 
a  crista  pyramidalis. 

513.     2.  The  semicircular  canals,  canales  semicircular  es, 

three  curved,  rather  elliptical  cylinders,  of  half  a  line  in  diameter, 
lying  behind  the  vestibule,  two  vertically  and  one  horizontally  be- 
tween them.  They  open  with  the  two  extremities,  which  are  rather 
wider  than  the  rest  of  the  canals,  into  the  vestibule,  as  one  extre- 
mity is  expanded  like  a  flask  (ampulla),  but  with  only  five  orifices. 

a.  The  superior  (vertical)  semicircular  canal,  about  six  lines  long,  at  the 
most  superior  part  of  the  labyrinth,  in  the  transverse  diameter  of  oss.  petrosi ; 
is  convex  above,  and  projects  rather  below  the  superior  surface  of  the  petrous 
bone.     Its  anterior  crus  expands  and  opens  alone,  on  the  superior  wall  of  the 
vestibule  ;  its  posterior  crus  in  common  with  the  superior  of  the  inferior  semi- 
circular canal,  and  without  expanding  on  the  superior  and  internal  wall  of  the 
vestibule. 

b.  The  inferior  (vertical)  semicircular  canal,   seven  lines  long,   narrower 
than  the  other  two,  describes  almost  a  complete  circle,  is  situated  parallel  with 
the  posterior  surface  of  the  petrous  bone,  with  its  convexity  directed  back- 
wards and  outwards  towards  proc.  mastoideus.     Its  superior  crus  opens  in 
common  with  a  ;  its  inferior  expanded  crus,  one  line  distant  from  that  on  the 
inferior  wall  of  the  vestibule. 

c.  The  external  (horizontal)  semicircular  canal,  four  lines  long,  but  wider  than 
the  other  two,  also  lies  in  the  long  diameter  of  the  petrous  bone,  with  the  con- 
vexity directed  outwards.     Its  anterior  expanded  crus  commences  close  above 
the  fenestra  ovalis,  below  the  crus  of  the  superior  semicircular  canal;  its  pos- 


THE  SENSES.  279 

terior  crus  opens  between  the  common  orifice  of  the  two  vertical  canals  and 
the  inferior  (ampulla)  of  the  inferior  semicircular  canal. 

514.  3.  The  Cochlea^  a  twisted  canal,  like  a  snail-shell,  of 
four  lines  axial  diameter,  occupies  the  most  anterior  space  of  the 
internal  ear,  is  situated  internally  and  before  the  tympanum  with 
its  basis  turned  to  the  base  ofmeatus  auditorius  internus,  the  apex 
towards  tuba  Eustachii.  The  canal,  canalis  spiralis,  consists  of 
two  and  a  half  spiral  turns,  the  length  of  which  together  measures 
one  inch,  commences  with  its  wide  basis  behind  the  promontorium, 
and  contracts  inwards  towards  the  apex  (cupola),  under  which  it 
terminates  in  a  funnel-shaped  cavity  (scyphus).  The  spirals  pass 
in  the  right  ear  to  the  right,  in  the  left  towards  the  left.  The  ca- 
vity of  the  canal  is  divided  by  a  thin  septum,  spiral  plate,  from  the 
basis  to  the  apex  into  a  superior  ladder  (scala  vestibuli),  and  into 
an  inferior  (scala  tympani). 

The  spiral  plate  (lamina  spiralis)  follows  the  windings  about 
the  axis  of  the  Cochlea,  to  which  it  is  attached  by  its  internal  bor- 
der, whilst  the  external  border  is  attached  to  the  circumference  of 
the  Cochlea.  It  consists  of  an  osseous  portion  zonula  ossea,  which 
occupies  the  internal  half  attached  to  the  axis  and  predominates  in 
the  first  turn,  and  of  a  membranous,  external  half,  zona  ValsalvcB. 
The  osseous  lamina  terminates  in  the  third  turn  with  a  kind  of 
hook,  hamulus  s.  rostrum  [where  tbe  scala  communicate,  canalis 
scalaris  communis,  Cassebohm ;  Helicotrema,  Breschet],  and  it- 
self consists  of  two  plates,  between  which  many  canaliculi  for  the 
nerves  of  the  Cochlea  are  found. 

The  axis,  spindle,  modiolus  s.  columella,  is  the  porous  mass  of 
bone  which  fills  up  the  space  in  the  axis  of  the  Cochlea,  bounded 
by  the  concavity  of  the  spirals.  Its  basis,  perforated  by  many  spi- 
rally arranged  foramina  (tractus  forami?iulentus,  for  the  nerv. 
Cochlece),  rests  upon  the  base  of  the  meatus  auditor,  internus; 
above  the  first  turn  the  mass  is  rather  thickened,  and  is  then  called 
columella,  and  terminates  as  lamina  terminalis,  of  a  funnel  shape 
in  the  half  turn.  The  external  surface  of  the  modiolus  is  provided 
with  two  screw-like  grooves  which  communicate  through  their  nu- 
merous foramina  with  the  same  number  of  canaliculi  in  the  inte- 
rior of  the  modiolus,  the  largest  of  which  in  the  centre,  canalis 
centralis  modioli,  passes  from  the  basis  to  the  lamina  terminalis. 

The  Scalae : 

a.  Scala  vestlbuli,  is  wider  than  b,  lies   more  anteriorly  and 
above  and  opens  into  the  vestibule  (aditus  ad  cochleam.) 

b.  Scala  tympani,  lies  more  towards  the  basis  and  opens  through 
the  fenestra  rotunda  (clausa)  into  the  tympanum.     Both  scalse 


280  SPECIAL  ANATOMY. 

communicate  in  the  lamina  terminalis  through  an  opening  in  the 
membrane  which  separates  them  (see  before). 

Aquceductus  cochlea  (Cotugno)  opens  into  the  scala  tympani 
close  before  fenestra  rotunda,  and  opens  on  the  other  side  on  the 
inferior  border  of  the  petrous  bone  close  to  fossa  jugularis. 

Both  the  aqueduct  of  the  cochlea  and  vestibule  are  at  last  regarded  as  ca- 
nals for  small  veins.  Arnold,  however,  thinks  still  that  they  serve  as  vent 
canals.  The  delicate  membrane  with  which  they  are  lined  passes  over  into 
the  dura  mater  and  the  periosteum  of  the  petrous  bone. 

515  3.  The  membranous  labyrinth. 

In  the  interior  of  the  labyrinth,  which  is  covered  with  a  delicate 
vascular  membrane  (choroidea  labyrinthi,  Arnold),  we  find  a  wa- 
tery fluid  (aqua  Cotunnii,  Perilympha),  in  which — but  only  in 
the  vestibule  and  the  semicircular  canals — a  whitish,  transparent 
nervous  membrane  is  suspended  (labyrinihus  membranaceus). 
The  last  forms  in  the  vestibule  two,  in  the  semicircular  canals  three 
sacs  filled  with  the  aquula  vitrea.  Zona  Valsalvce  (see  before) 
separates  the  two  scalez,  the  humor  aqueus  of  which  flows  through 
the  opening  at  the  lamina  terminalis  [helicotrema]  from  the  one 
into  the  other. 

a.  Canales   semicirculares  membranacei,  far  more  narrow,  but  otherwise 
similar  to  the  osseous  semicircular  canals,  in  which  they  lie,  they  are  ex- 
panded in  the  internal  crura  (ampullae)  and  open  with  five  orifices  into  the 

b.  Vestibulum  membranaceum.     This  consists  of  two  portions. 

1.  Sacculus  oblongus  (s.  utriculus  ventricularis)  receives  alone  the  five 
semicircular  canals,  is  larger  than  2.,  lies  in  the  recessus  hemiellipticus, 
separated  from  the  Stapes  only  by  the  aq.  Cotunnii. 

2.  Sacculus  rotundus  is  much  smaller,  lies  in  the  recessus  hemisphericus 
under  the  former  without  communicating  with  it,  and  the  n.  saccularis 
minor  spreads  out  in  it. 

c.  Aquula  vitrea  (Scarpa)  s.  Endolympha;  rather  a  thicker  fluid  than  the 
aq.  Cotunnii,  fills  up  the  membranous  tubes  and  sacs  of  the  labyrinth  and  con- 
tains a  fine  crystalline  deposit. 

Otoconia,  sand  of  the  ear,  otolithi,  stones  of  the  ear ;  these  are  smaller  or 
larger  accumulations  of  six-sided  columns  consisting  of  carbonate  of  lime,  and 
an  organic  material  (Huschke)  which  in  the  vestibule  adhere  opposite  to  the 
expansion  of  the  nerves,  and  serve  for  the  strengthening  of  the  sounds. 
Larger  and  more  distinct  in  the  lower  classes  of  animals  (and  in  the  embryo) 
their  structure,  in  man,  in  spite  of  the  researches  of  Breschet,  Krieger,  and 
others,  is  not  yet  determined. 

Vessels  and  nerves  of  the  labyrinth.  Artt.  cochleae  and  vestibuli  are  branches 
of  art.  auditoria  interna,  and  correspond  to  the 


THE  SENSES.  281 

Nerves :  N.  cochlea,  the  anterior  stronger  branch  of  n.  acusticus  enters 
through  the  inferior  anterior  fossa  of  meat,  auditor,  internus  at  the  basis  of  the 
modiolus  in  its  canals,  and  thence  between  the  layers  of  the  lamina  spiralis, 
where  the  most  delicate  fasciculi  (in  loops)  spread  out  as  far  as  the  external 
border.  N.  vestibuli,  the  posterior  branch  of  the  acusticus,  divides  at  the 
basis  of  meatus  auditorius  internus  into  three  fasciculi,  the  strongest  of  which 
goes  to  the  sacculus  oblongus  and  the  Ampulla  of  the  vertical  superior  and 
horizontal  semicircular  canal;  the  central  to  the  sacculus  rotundus,  and  the 
inferior  smallest  to  the  ampulla  of  the  vertical  inferior  semicircular  canal. 

516.  III.  The  Organ  of  Smell,  Organon  olfactus. 

The  nose,  nasus,  consists  of  an  external  portion  projecting  upon 
the  face  and  an  internal  covered  with  mucous  membrane. 

517.  A.  The  external  Nose,  Nasus  exlernus, 

consists,  above,  of  an  osseous  (ossa  nasi  and  process,  nasales) 
below,  of  a  cartilaginous  skeleton,  which  are  immediately  covered 
with  periosteum  and  perichondrium,  nearer  the  surface  with 
muscles  (see  Myology),  and  cutis,  on  the  internal  surface  with 
mucous  membrane.  Portions  :  The  root  of  the  nose,  close  under 
the  forehead, — the  back  or  dorsum  of  the  nose, — the  point  or  tip 
of  the  nose, — the  lateral  parietes,  alee  s.  pinnce  nasi, — openings 
of  the  nose,  nares,  the  partition,  septum  narium. 

518.  1.  The  Nasal  cartilages,  five,  Cartilagines  nasi. 

a.  Cartilago  lateralis,  the  lateral  cartilages,  are  situated  (one  on  either 
side)  at  the  most  superior  part  of  the  cartilaginous  nose ;  triangular, 
attached  above  and  behind  by  fibrous  uniting  tissue  with  ossa  nasi. 
The  internal  borders  of  the  two  meet  upon  the  dorsum  nasi,  where 
they  are  also  firmly  attached  to  the  cartilage  of  the  septum.     The  infe- 
rior border  is  convex,  and  meets  anteriorly  with  b,  behind  with  the 
fibrous  membrane  of  the  aloe  nasi. 

b.  Cartilago  narium  (s.  spinalis),  one  on  either  side,  is  a  more  irregular 
semi-elliptical  cartilage,  the  external  thinner  arch  is  situated  in  the 
groove  above  the  alee  nasi  and  point,  whilst  the  internal  reaches  below 
the  septum  mobile  as  far  as  the  spina  nasalis.     A  fibrous  plate  between 
the  pinnal  cartilages  and  the  inferior  border  of  the  lateral  nasal  carti- 
lages forms  the  skeleton  of  the  alee  nasi,  in  which  (generally)  small  flat 
cartilaginous  nuclei  (cart,  sesamoidece)  exist. 

c.  Cartilago  septi  narium,  the  septal  cartilage,  thick,  flat,  and  triangular, 
meets  with  its  superior  posterior  border,  the  lamina  perpendicularis  of 
the  Ethmoid  bone  ;  its  inferior  border  is  placed  between  the  two  plates 
of  the  Vomer;  its  anterior  border  unites  upon  the  back  of  the  nose  with 
the  cartt.  laterales,  and  below  with  the  cartt.  narium.    Behind  a  pro- 


282  SPECIAL  ANATOMY. 

cess  projects  from  it  into  the  angle  between  lamina  perpendicularis  oss- 
ethmoid.  and  Corner.    It  separates  the  two  halves  of  the  nasal  cavity. 

2.  The  muscles  of  the  nose  :  levator  Idbii  alceq.  nasi,  compressor  and  dilata. 
tores  narium,  depressor  aloe  nasi,  pyramidalis  and  depressor  septi  mobilis  (see 
Myology). 

3.  The  skin  of  the  nose  is  very  thick  and  strong  on  the  ala  nasi  and  below 
the  septum,  and  passes  at  the  nares  into  the  mucous  membrane,  the  com- 
mencement of  which  is  beset  with  stiff  hairs  (vibrissce}.     It  is  also  furnished 
with  many  folliculi  sebacei,  which  frequently  appear  as  black  punctules. 

4.  Vessels  and  nerves.     Arteries:  branches  of  maxillaris  externa,  infra- 
orbitalis,  and  ophthalmica.     Veins  form  plexus  nasalis.     Nerves:  branches  of 
plex.  infraorbitalis  and  of  N.  ethmoidalis. 

519.        B.  The  Cavity  of  the  Nose,  Nasus  internus. 

The  cavities  of  the  nose,foss<z  nasales,  are  covered  with  the  nasal 
mucous  membrane,  membrana  pituitaria  s.  Schneideriana,  the 
proper  seat  of  the  sense  of  smell.  This  membrane  is  thick,  soft, 
rosy  red,  very  vascular  and  largely  supplied  with  nerves  (in  the 
neighbouring  cavities,  sinus  frontales,  ethmoidal.,  sphenoidal.,  and 
antrum  Highmori,  we  find  instead  of  it  a  delicate,  fine  periosteum 
covered  with  ciliated  epithelium.)  Numerous  mucous  follicles  cover 
the  free  surface,  whilst  the  external  is  firmly  attached  to  the  peri- 
osteum and  perichondrium.  It  continues  upon  the  palate  and  pha- 
rynx, the  lacrymal  canal,  and  Eustachian  tube,  the  openings  of 
which,  as  well  as  those  of  the  sinus,  it  generally  covers  like  a  veil. 
[There  is  ciliated  epithelium  on  the  mucous  membrane  lining  the 
nose.] 

We  observe  in  it  the  meatus  narium: 

1.  The  superior  nasal  chamber,  below  the  superior  turbinate  bones,  with 
the  openings  of  the  posterior  ethmoidal  and  the  sphenoidal  cells. 

2.  The  central  nasal  chamber,  below  the  middle  turbinate  bones,  with 
the  openings  of  the  anterior  ethmoidal  cells,  the  sinus  frontalis,  and 
antra  Higlimori. 

3.  The  inferior  nasal  chamber,  below  the  inferior  turbinate  bones,  with 
the  openings  of  the  canal,  lacrymal. 

Vessels  and  Nerves :  Art .  sphenopalatina  and  ethmoidalis.  Veins :  form 
very  large  plexuses,  and  pass  into  plex.  pterygoid.  and  ven.  maxillar.  interna. 
Lymphatics :  form  a  very  close  superficial  rete. 

Nerves :  Nn.  olfactorii,  ethmoidales,  naso-palatini  Scarpce,  and  nasales, 
(Branches  of  Nerv.  trigeminus'). 


ANGIOLOGIA. 

VASCULAR  SYSTEM. 


"  In  the  history  of  Physiology,  I  have  shown  that  those  who  studied  the 
structure  of  animals  were  irresistibly  led  to  the  conviction  that  the  parts  of 
this  structure  have  each  its  end  or  purpose  ;  that  each  member  and  organ 
not  merely  produces  a  certain  effect  or  answers  a  certain  use,  but  is  so 
framed  as  to  impress  us  with  the  persuasion  that  it  was  constructed  for  thai 
use  ;  that  it  was  intended  to  produce  the  effect.  It  was  there  seen  that  this 
persuasion  was  repeatedly  expressed  in  the  most  emphatic  manner  by  Galen  ; 
that  it  directed  the  researches  and  led  to  the  discoveries  of  Harvey ;  that  it 
has  always  been  dwelt  upon  as  a  favourite  contemplation,  and  followed  as  a 
certain  guide  by  the  best  anatomists  ;  and  that  it  is  inculcated  by  the  physio- 
logists of  the  profoundest  views  and  most  extensive  knowledge  of  our  own 
time.  All  these  persons  have  deemed  it  a  most  certain  and  important  prin- 
ciple of  physiology,  that  in  every  organized  structure,  plant,  or  animal,  each 
intelligible  part  has  its  allotted  office  ;  each  organ  is  designed  for  its  ap- 
propriate function;  that  nature,  in  these  cases,  produces  nothing  in  vain; 
that,  in  short,  each  portion  of  the  whole  arrangemen  thas  its  final  cause;  an 
end  to  which  it  is  adapted,  and  in  this  end  the  reason  that  it  is  where  and 
what  it  is." — WHEWELL.  Indications  of  the  Creator,  p.  75. 


ANGIOLOGIA. 

LITERATURE. 

Blood  Vessels  :— 

Reid,  J.    Art.  "  Heart"  Cycl.  of  Anat.  and  Phys. 

Chevers,  N.  The  fibrous  Structure  of  the  subserous  Membrane  of  the  Aorta 
Guy's  Hosp.  Rep.  vol.  v. 

Structure  of  the  Coronary  Arteries  of  the  Heart.  Guy's  Hosp. 

Rep.  vol.  i.  2d  series. 

Davy,  John.  On  the  Vessels  of  the  Brain.  Edin.  Med.  and  Surgical  Jour- 
nal, 1839. 

King,  T.  W.  Safety  Valve  Function  of  Human  Heart.  Guy's  Hosp.  Rep. 
vol.  ii. 

—    On  the  Pulsation  in  the  Veins.     Med.  Gaz.  vol.  xviii. 

Harrison.     Surgical  Anatomy  of  the  Arteries.     Last  edition. 

Hart,  J.     Art.  "  Artery"  Cycl.  of  Anat.  and  Phys. 

Thomson,  Allen.     Art.  "  Circulation,"  in  the  same. 

Lymphatics  :  — 

Cruikshank.    Anat.  of  the  Absorbent  Vessels.    4to.     1790. 
Lippi.     On  the  Absorbents— for  Drawings.     1831. 
Sheldon.    Hist,  of  the  Absorbent  System.     Figures.     1784. 
T.  W,  King.     On  the  Circulation  in  the  Lymphatics.     Guy's  Hosp.  Rep. 

vol.  v. 

Hewson.    His  Works.     Sydenham  Society. 
Bostock,  /.    Art.  "Absorption,"  Cycl.  of  Anat.  and  Phys. 
Lane,  S.     Art.  "  Lymphatic  System,"  in  the  same. 


285 


520.  THE  VASCULAR  SYSTEM. 

The  nutritious  fluid  moves  in  closed  flexible  tubes,  which  tra- 
verse the  body  in  all  directions.  That  division  of  these  tubes, 
through  which  the  blood  moves,  has  a  contractile  organ  as  the 
central  point,  from  which  blood  is  impelled  into  the  tubes,  and  to 
which  it  returns  from  the  tubes. 

The  other  division,  in  which  the  Chyle  and  Lymph  move,  does 
not  possess  in  itself  such  a  central  point,  but  in  the  blood  sys- 
tem, to  which  it  carries  its  contents,  without  being  immediately 
distributed  from  its  orifice. 

521.  The  System  of  Vessels  carrying  Blood. 

Central  organ — the  heart.  From  it  vessels  go  off — the  arteries 
(pulsating  vessels).  To  it  vessels  lead  back — the  veins  (blood 
vessels).  Very  delicate  ramifications  and  transitions  between  the 
two  kinds  of  vessels.  Capillary  vessels. 

522.  Course.     The  vessels,  vasa,  are  cylindrical  tubes,  the 
largest  trunks  of  which  lie  in  the  neighbourhood  of  the  central 
organs,  and  the  branches  of  which,  going  off  at  an  acute  angle, 
diminish  in  circumference  towards  the  periphery.     The  effect  of 
this  continued  division  however  is,  that  the  calibre  of  the  branches 
taken  together  is  wider  than  that  of  the  trunk  from  which  they 
came  off. 

Many  branches  divide  from  one  trunk,  and  pass  to  another, 
without  diminishing  in  circumference,  that  is,  they  anastomose. 
Their  course  is  curved  or  in  the  form  of  an  acute  angle.  If 
they  are  numerous,  and  the  interspace  between  them  only  small 
in  proportion  to  the  organ,  they  are  called  Plexuses,  which  is 
particularly  remarkable  in  the  venous  trunks.  When  larger 
branches  suddenly  divide  into  a  number  of  smaller  vessels  united 
together,  without  previous  arborescent  separation,  the  so-called 
rete  mirabile  is  formed,  for  example,  in  the  lungs.  The  capil- 
lary vessels  also  form  a  network,  but  which  by  gradual,  always 
more  delicate,  division,  arises  from  large  vessels.  The  more  nar- 
row and  complicated  the  course  through  which  the  blood  has  to 
circulate,  so  much  the  longer  it  is  delayed  therein. 

Structure  of  the  vessels.  The  parietes  of  the  vessels  consist  of  six  mem- 
branous layers,  which  are  not,  however,  always  present  at  the  same  time  in 
every  vessel. 

a.   The  innermost  layer,  which  lies  next  to  the  cavity  of  the  vessel,  is  a  thin, 


286  SPECIAL  ANATOMY. 

granular  membrane  of  pavement  epithelium,  which  is  also  seen  in  the  most 
delicate  capillaries. 

b.  The  striated  or  fenestrated  membrane  is  delicate,  clear,  fragile,  and 
rolls  up  at  the  corners. 

c.  The  longitudinal,  fibrous  membrane  is  distinctly  seen  in  large  vessels. 
It  is,  like  a.  and  b.,  formed  of  oval  cell  nuclei  or  fibres,  which  are  placed  lon- 
gitudinally, in  which  direction  the  membrane  may  be  torn  off;  and  it  was 
formerly  considered,  with  a.  and  b.  as  the  most  internal  layer  of  the  vessels. 

d.  The  circular,  fibrous  coat  (so-called  tunica  med.}  is  thick,  contracting 
upon  certain  stimuli  (falsely,  tun.  elastica)',  consists  of  short  parallel  fibres, 
which  are  soluble  in  acetic  acid,  and  of  dark  striae,  which  are  only  rendered 
transparent  by  the  acid  ;  it  is  fragile,  and  tears  off  transversely. 

e.  The  elastic  coat  is  only  present  in  the  larger  arteries  and  veins ;    is 
white,  thinner  than  d. ;  is  neither  soluble  in,  nor  rendered  transparent  by  ace- 
tic acid  ;  tears  off  neither  in  the  longitudinal  nor  transverse  direction,  and 
consists  of  very  branched,  often  reteform,  fibres. 

f.  The  external  tunic  (tun.  adventitia)  forms  with  e.  the  hitherto  so-called 
tunica  externa;  it  consists  of  fibro-cellular  tissue,  with  oval  nuclei  in  a  longi- 
tudinal direction,  and  passes  from  the  larger  vessels  into  the  surrounding 
amorphous,  fibro-cellular,  or  uniting  tissue. 

The  nutrition  of  the  larger  vessels  (above  half  a  line  diam.)  is  supplied  by 
small  arterial  twigs  (vasa  vasorum),  which  do  not  come  immediately  from  the 
cavity  of  the  vessel  for  which  they  are  destined,  whilst  the  venous  ramusculi 
open  into  those  veins,  from  the  coats  of  which  the  blood  collects.  The  vasa 
vasorum  themselves,  as  well  as  the  capillary  vessels,  are  nourished  by  the 
blood  circulating  in  them. 

Nerves :  (nervi  vasorum)  the  vessels  obtain  their  supply  from  the  N.  Sym- 
pathicus. 

523.  I.    Capillary  vessels,  vasa  capillaria, 

are  the  blood-vessels  intermediate  between  the  arteries  and  veins,  the 
branches  of  which  form  a  net-work  with  each  other,  and  tolerably  equally- 
sized  meshes.  In  these  meshes  is  placed  the  peculiar  substance  of  the  tissue, 
and  it  receives  its  nutrition  from  the  blood  of  the  vessels  (metamorphosis  of 
matter).  The  blood  circulating  in  them  is  neither  arterial  nor  venous ;  in  the 
finest  vessels  it  appears  colourless ;  it  generally  flows  in  a  direction  from  the 
arteries,  which  here  terminate,  to  the  veins,  which  commence  at  this  point. 
Ii  is  impossible  to  draw  a  definite  limit  between  the  terminations  of  the  arte- 
ries and  the  commencement  of  the  veins.  Structure.  In  the  parietes  of  the 
capillary  vessels  (which  are  not  merely  canals  in  the  parenchyma  of  organs), 
pavement  epithelium,  and,  most  externally,  a  tunic  of  areolar  tissue,  has  been 
ibund. 

The  forms  of  their  network  vary  according  to  the  diameters  of  the  vessels 
(the  finest  in  the  brain  =  O'OOS  of  a  line  ;  the  largest  in  the  medulla  of  the 
bones  =  O'OIO  af  a  line) ;  according  to  4he  breadth  of  the  meshes,  which  is  so 


THE  VESSELS.  287 

much  the  more  minute,  the  larger  the  consumption  of  blood  (the  narrowest 
network  is  in  the  lungs,  the  glands  of  the  skin,  the  mucous  membranes,  &c.) 
According  to  the  shape  of  the  space  bounded  by  them,  we  may  distinguish 
roundish  or  oval  (e.  g.  in  the  lungs,  the  corium,  the  glands),  and  longitudinal 
or  elongated  meshes  (in  the  nerves  and  muscles).  Ball-shaped,  convoluted 
meshes  are  only  found  in  the  cortical  substance  of  the  kidneys  (e.  g.  glomeruli 
Malpighi). 

Function.  The  capillary  vessels  impart,  through  their  thin  (not  porous) 
walls,  the  nutritious  material  of  their  blood  to  the  organs,  in  which  they 
spread  out  and  ramify,  and  on  the  other  side  they  take  up,  likewise  (in  the 
lungs),  the  inspired  oxygen.  Vasa  exhalantia,  exhaling  vessels. 

524.  II.    Pulsating  vessels,  arterice, 

are  the  vessels,  the  trunks  of  which  arise  from  the  ventricles  of  the  heart,  and 
which  distribute  the  blood  throughout  the  body.  Their  walls  are  thicker, 
and  more  elastic  than  the  rest  of  the  vessels.  The  smaller  arteries  possess, 
relatively,  the  strongest  parietes  ;  the  thinnest  arteries  are  those  of  the  cranial 
cavity.  They  pulsate,  that  is,  they  extend  in  length  and  breadth,  when  the 
ventricles  of  the  heart  contract  (systole),  and  thereby  force  their  blood  into  the 
arteries,  and  they  again  become  narrower  and  shorter,  when  the  ventricles  of 
the  heart  dilate  (diastole).  The  arteries  are  further  distinguished  by  their 
great  elasticity  and  contractility.  The  first  produces  retraction  when  the  ar- 
teries are  divided  across  ;  the  last  a  narrowing,  but  not  collapse,  as  happens 
in  the  veins.  Of  the  coats,  before  all,  we  remark : 

That  consisting  of  circular  fibres  (the  so-called  middle,  elastic  coat).  It  is 
thick,  yellowish  white,  dry,  and  fragile,  and  the  medium  of  contraction.  It 
is  distinguished  from  the  muscular  tissue  by  its  easy  solubility  in  nitric,  inso- 
lubility in  acetic  acid,  and  by  yielding  gelatine  on  boiling  ;  from  the  fibro-cel- 
lular  or  uniting  tissue,  by  insolubility  in  boiling  acetic  acid,  difficult  solution 
in  mineral  acids,  caustic  potash,  and  gastric  juice. 

The  external,  properly  elastic  coat  of  arteries,  is  firm,  and  stronger  than  in 
the  veins,  and  is  remarkable  for  not  dividing  when  an  artery  is  included  in  a 
ligature,  which  the  internal  coat  does. 

The  inner  coat,  tun.  vasorum  comm.,  that  is,  the  striated  tunic  (for  the  tunic 
of  longitudinal  fibres  is  usually  wanting),  is  only  in  a  diseased  condition  as 
thick  as  we  are  accustomed  to  find  it,  especially  in  old  people,  when  it  is  BO 
much  the  more  fragile. 

The  arteries  take  a  serpentine  course,  generally  deeper  than  the  veins  and 
lymphatics,  the  larger  on  the  flexion  side  of  the  joints,  and  convey  (the  pul- 
monary excepted)  bright  red  blood. 

525.  III.   Blood-vessels,  vence,  veins, 

originate  from  the  capillaries,  and  open  into  the  auricles  of  the  heart.  Their 
walls  are  thinner,  and  more  lax,  and  when  the  vessel  is  empty,  they  fall  toge- 
.her,  as  the  elastic  coat  is  entirely  wanting  in  them ;  the  contractile,  circular, 


288  SPECIAL  ANATOMY. 

fibrous  coat,  much  thinner,  or  only  consisting  of  bundles  of  fibro-cellular  tis- 
sue, in  place  of  which,  on  the  superior  and  inferior  cavce,  and  on  the  pulmo- 
nary veins,  muscular  tissue  is  found.  The  tunic  of  longitudinal  fibres  (here 
tunica  interna)  is  always  present  in  the  larger  veins;  it  does  not  easily  lace- 
rate. The  striated  tunic  and  epithelium  line  them  inside,  in  thinner  or  thicker 
layers. 

Peculiar  to  the  veins  are  their  valves,  valvulce,  which  are  semilunar  flaps  of 
fibrous  tissue,  the  free  concave  border  of  which  is  directed  towards  the  heart, 
and  which  closes  up  the  calibre  of  the  vessel  against  the  retrograde  course  of 
the  blood.  In  small  vessels  (of  one  line  diam.),  single,  in  larger,  two  or  three 
placed  opposite  each  other,  the  valves  are  wanting  in  the  abdominal,  and 
chiefly  in  those  veins  which  are  protected  against  the  pressure  of  the  column 
of  blood  or  the  pressure  of  muscles  on  hard  parts ;  they  are,  on  the  contrary, 
especially  numerous  in  the  inferior  extremities.  In  the  larger  valves  we'find 
two  layers,  and  fat.  Moreover  they  are  not  duplicatures  of  the  internal  coat 
(see  Lymphatics). 

The  veins  generally  take  a  straight  course,  are  wider,  and  form  more  fre- 
quent anastomoses  than  the  arteries,  and  carry  (the  pulmonary  veins  excepted) 
dark  red  blood,  rich  in  carbon. 

526.    IV.    Lymphatics,  vasa  lymphatica  s.  resorbentia, 

form  a  system  of  vessels  which  must  be  considered  as  an  appendage  to  the 
venous  system.  The  tubes  are  narrow,  thin-walled,  flat,  and  provided  with 
numerous  valves.  The  commencements  of  the  lymphatics  probably  form  a 
rete,  the  tubes  of  which,  like  those  of  the  capillaries,  are  of  pretty  equal  size, 
and  which  are  to  be  sought  upon  the  surface  and  in  the  parenchyma  of  all 
organs.  From  the  retethe  minute  tubules  coalesce,  generally  pass  in  a  straight 
course  with  the  blood-vessels,  form  Plexuses,  here  and  there  convoluted, 
complicated  ganglia,  lymphatic  glands,  and  lastly,  one  large  trunk  (or  several), 
which  opens  into  a  great  vein. 

Those  lymphatics  are  called  chyle  vessels,  which  arise  inside  the  intestinal 
villi  beneath  the  mucous  membrane  (of  the  small  intestines),  not  with  rete- 
form,  but  with  fine,  club-shaped,  closed  tubes. 

Structure.  The  walls  of  the  lymphatics  are  transparent,  more  delicate,  but 
more  extensible,  and  stronger  than  those  of  the  blood-vessels.  In  the  larger 
trunks  we  also  distinguish  in  them :  a.  an  innermost  layer  of  pavement  epi- 
thelium ;  b.  a  coat  of  longitudinal  fibres;  c.  a  coat  of  circular  fibres,  with  fas- 
ciculi of  areolar  tissue,  which  blends  with  the  surrounding  uniting  and  adipose 
tissues. 

The  numerous  valves,  generally  arranged  in  pairs,  consist  of  fibro-cellular 
tissue,  with  fibrous  unyielding  rings  attached  to  the  walls  of  the  lymphatics, 
which  produce  contractions  in  the  distended  vessels,  and  therefore  a  knotted 
appearance. 

The  function  of  the  lymphatics  consists  in  the  reception  of  the  Plasma 
(Lymph)  passing  out  of  the  blood-vessels,  and  of  the  nutritious  fluid  (Chyle) 
formed  in  the  intestinal  canal. 


THE  VESSELS.  289 

They  are,  therefore,  wanting  in  non-vascular  parts,  e.  g.  in  the  teeth,  the 
crystalline  lens,  &c.  They  are  probably  not  wanting  in  the  substance  of  the 
brain,  spinal  cord,  eye,  internal  ear,  placenta,  the  membranes  of  the  egg,  and 
the  umbilical  cord,  although  they  have  not  been  yet  found  in  them. 

Lymphatic  glands,  glandults  lymphaticcs  s.  conglobatce,  are  oval,  generally 
flattened  and  reddish  bodies,  with  a  smooth,  even  surface,  and  one  line  to  an 
inch  in  diam.,  lying  generally  dispersed  in  groups,  especially  in  the  popliteal 
and  inguinal  regions,  the  axillary  fossa  in  the  neck,  at  the  roots  of  the  lungs 
(black),  in  the  mesentery,  and  in  the  liver  (yellow),  but  never  in  the  substance 
of  organs.  The  larger  are  invested  by  a  fibrous  tunic,  and  contain  (besides 
the  numerous  convolutions  and  ramifications  of  the  lymphatics,  besides  the 
amorphous  areolar  tissue,  blood-vessels  and  nerves)  small  cellular  spaces, 
with  granules  (acini),  and  thus  form,  perhaps,  actual  glands,  like  the  spleen, 
in  which  the  lymph  obtains  a  particular  substance,  which  it  prepares  for  the 
change  into  blood.  Almost  every  lymphatic  vessel  passes  into  one  of  these 
glands  and  out  again  (vasa  in-  and  efferentia). 

A  delicate  capillary  rete,  investing  the  lymphatic  glands  and  vessels  very 
abundantly,  serves  to  nourish  them.  Nerve  filaments  have  been  at  least 
found  in  the  lymphatic  glands. 

527.  The  heart,  Cor,  xap&a, 

A.  hollow  conical  muscle,  lies,  surrounded  by  a  serous  envelope 
(pericardium),  in  the  centre  of  the  thorax,  between  the  lungs,  above 
the  diaphragm,  behind  the  sternum  and  before  the  vertebral  co- 
lumn, in  rather  an  oblique  direction  from  above  downwards,  from 
right  to  left,  and  from  behind  forwards. 

It  is  composed  of  two  halves,  a  right  venous  and  a  left  arterial, 
each  of  which  is  again  separated  by  a  septum  into  two  commu- 
nicating portions.  The  heart  contains  four  cavities,  viz. : 

the  auricle  (atrium)  and  the  ventricle  (ventriculus)  of  the 

right,  and 
the  auricle  and  ventricle  of  the  left  side  of  the  heart. 

The  cavities  are  lined  by  tunica  vasorum  communis  [endocar- 
dium], the  outer  surfaces  receive  a  continuation  from  one  of  the 
layers  of  the  pericardium. 

We  have  to  observe  of  the  Heart :  a.  the  basis,  that  is,  the 
superior  and  posterior  part,  at  which  point  the  vessels  enter  and 
from  which  they  pass  out,  which  lies  behind  the  right  border  of 
the  Sternum,  before  the  eighth  to  the  sixth  dorsal  vertebra,  and 
is  bounded  by  sulc.  circularis.  b.  The  apex,  apex  s.  mucro,  ob- 
tuse and  slightly  curved  backwards  towards  the  space  between  the 
sixth  and  seventh  left  ribs,  presents  a  depression,  vallecula,  with 
two  elevations,  c.  The  superior,  convex  surface  looks  towards 
the  sternum,  the  inferior  flat  rests  upon  the  diaphragm,  d.  The 

19 


290  SPECIAL  ANATOMY. 

rounded  lateral  edges  point  out  the  direction  of  the  heart  from 
right  to  left.  e.  Sulcus  longitudinalis,  that  is,  a  shallow  groove 
which  passes  downwards  from  the  basis  as  far  as  the  apex  in  a 
curved  course  and  indicates  the  septum  between  the  right  and  left 
half  of  the  heart,  f.  Sulcus  circularis,  a  deep  transverse  groove 
which  marks  out  the  boundary  between  the  auricles  and  ven- 
tricles. 

Measurements.  Length  =4|  inches, 
Breadth  =3|  inches, 
Thickness=2£  inches, 
Capacity  =32  cub.  inches. 

Weight.  In  male     =9  ounces, 

In  female  =8  ounces,  5  drachms. 
After  the  thirtieth  year  it  always  rather  increases. 

1.  The  auricles,  atria,  are  to  be  regarded  as  dilatations  of  the  large  veins, 
the  blood  from  which  they  receive,  and  pour  it  (through  ostia  venosa)  into  the 
ventricles.     They  are  situated  at  the  most  external  portion  of  the  basis  cordis, 
are  nearly  quadrangular,  two  inches  high  and  broad,  provided  with  thin  walls, 
and  a  blind,  pocket-like  appendage,  auricle,  auricula  cordis,  and  separated 
from  one  another  by  a  partition  (septum  atriorum). 

The  anterior  surface  is  concave,  without  a  longitudinal  groove,  covered 
by  Aorta  said  Art.  pulmonalis. 

The  posterior  surface  is  convex,  presents  a  longitudinal  groove  (near 
it,  to  the  right,  the  opening  of  the  ven.  cava  infer.,  underneath,  that  of 
the  ven.  magn.  cordis  [coronary  vein] ,  and  is  separated  by  the  aorta  and 
oesophagus  only  from  the  vertebral  column. 

The  superior  extremity  looks  backwards  and  to  the  right,  lies  under 
the  bifurcatio  trachece,  presents  a  longitudinal  groove,  to  the  right  side  of 
which  lies  the  opening  of  Ven.  cava  superior,  to  the  left  are  seen  the  four 
openings  of  the  four  pulmonary  veins. 

2.  The  ventricles,  ventriculi  cordis,  give  origin  to  their  arteries,  and  force 
the  blood  which  they  have  received  from  the  auricles  into  them.    They  are 
situated  below  the  sulcus  transversus,  form  the  middle  and  the  apex  of  the 
heart,  and  are  provided  with  thick  external  walls,  and  a  partition  (septum 
cordis},  which  separates  the  one  from  the  other.    Their  anterior  surface,  par- 
ticularly the  part  which  lies  to  the  right  of  the  longitudinal  groove,  looks  to- 
wards the  sternum,  and  lies,  in  large  hearts,  immediately  behind  it. 

528.  The  Cavities. 

1.  Atrium  dextrum,  right  auricle,  caval  dilatation,  lies  behind  the  third  to 
the  sixth  costal  cartilage  and  the  body  of  the  sternum,  rather  covered  by  the 
anterior  border  of  the  right  lung.  From  its  superior  angle  the  right  appendix 
passes  inwards  and  upwards,  covering  the  commencement  of  the  aorta.  Its 


THE  VESSELS.  291 

cavity  is  formed  by  three  walls,  an  anterior  convex,  an  internal  (the  septum), 
and  a  larger  posterior,  concave.  It  presents  in  the  adult  three,  in  the  fetus 
four  openings. 

a.  The  crescentic  opening  of  the  superior  cava,  separated  by  a  fasciculus  of 
muscle  from  the  appendix  on  the  left,  from  the  inferior  cava  on  the  right, 
without  valves,  looks  downwards  and  rather  backwards. 

b.  The  crescentic  opening  of  the  inferior  cava,  larger  than  the  former,  close 
to  the  septum,  not  vertical  from  below  upwards,  but  directed  obliquely  (at  a 
right  angle  to  the  vein),  with  the  half-rnoon-shaped  valvula  Eustachii  on  the 
anterior  border,  which  completely  closes  the  opening  in  the  embryo  only. 
The  free  concave  border  of  the  Eustachian  valve  looks  upwards,  the  attached 
convex  downwards. 

c.  The  opening  of  vena  magna  cordis   [coronary  vein]  lies  before  the  last 
described,  separated  from  it  by  the  Eustachian  valve  ;  is  closed  by  a  thin, 
crescentic  valve,  valvula  Thebesii,  the  superior  extremity  of  which  continues 
into  the  inferior  of  the  valv.  Eustach. 

Several  small  foramina  Thebesii  are  found  below  the  opening  of  the  supe- 
rior cava,  but  they  are  not  to  be  considered  as  the  openings  of  smaller  cardiac 
veins. 

d.  Foramen  ovale,  in  the  embryo,  is  a  longitudinal  opening  in  the  posterior 
inferior  part  of  the  septum  between  the  auricles.    At  birth  is  already  found 
in  its  place  a  smooth  or  wrinkled,  but  thin  layer,  fossa  ovalis,  bordered  above 
and  before  by  a  crescentic,  fleshy  protuberance,  isthmus  Vieusstns,  the  inferior 
extremity  of  which  passes  into  the  Valv.  Eustachii.    A  depression  with  a 
small  foramen  is  frequently  found  in  the  oval  fossa  behind  the  isthmus,  as  the 
remains  of  the  oval  foramen. 

Valvula  foramin.  ovalis  (of  the  foetus)  is  the  membranous  portion  spread 
out  in  the  circle  of  Vieussens,  the  continuation  of  the  inner  coat  of  the  left 
circumference  of  ven.  cava  super'.,  whilst  the  valvula  Eustachii  proceeds  from 
the  right  circumference. 

Tuberculum  Loweri,  the  elevation  at  the  upper  part  of  stptum  atriorum, 
between  the  mouth  of  v.  cava  sup.  and  fossa  ovalis,  which  directs  the  stream 
of  blood  from  v.  cava  sup.  upon  the  posterior  inferior  circumference  of  the 
right  auricle,  and  that  of  v.  cava  infer,  forwards,  and  to  the  right  towards  the 
right  appendix. 

2.  Right  ventricle,  ventriculus  dexter.,  pulmonary  ventricle,  at  the  anterior 
inferior  part  of  the  heart,  directed  obliquely  to  the  left  and  downwards  from 
its  auricle,  does  not  reach  the  extreme  apex.  Its  internal  wall  (septum  ven- 
tricular.,) is  convex,  and  on  its  lower  half  like  trellis-work.  The  anterior  and 
inferior  walls  are  concave,  thin  and  loose,  and  beset  with  an  interlacement  of 
fleshy  fasciculi  (mm.  papillares),  as  they  are  found,  also,  particularly  deve- 
loped in  the  cavities  of  the  auricles.  At  its  base  the  two  following  openings 
are  found : 

a.  Right  auricular-ventricular  opening,  ostium  venosum,  at  the  posterior, 
right  part  of  the  base  of  the  ventricle,  is  elliptical  (from  before  to  behind),  six- 


292  SPECIAL  ANATOMY. 

teen  to  eighteen  lines  long,  twelve  lines  broad,  and  connects  the  auricle  with 
the  ventricle.  From  a  fibro-cartilaginous  ring,  which  encircles  it,  the  inner 
membrane  (endocardium)  forms  a  three-curtained,  annular  valve,  valvula  tri- 
cuspidalis,  tfiy^o^tva,  which  projects  with  its  smooth  surface  into  the  auricle, 
with  an  uneven  surface,  produced  by  small  tendinous  cords,  into  the  ventricle. 
The  cords  are  partly  attached  to  the  free  border,  partly  to  the  surface  of  the 
valve,  and  they  are  so  arranged  that  the  latter  becomes  stretched  when  their 
muscular  fasciculi  contract. 

b.  Arterial  opening,  ostium  arteriosum,  is  situated  at  the  anterior,  left  part 
of  the  base  of  the  ventricle,  is  separated  from  the  auricular  opening  by  a 
projecting  edge  of  muscle ;  it  is  circular,  and  surrounded  by  three  semilunar 
valves,  valva,  semilunares,  sigmoidece,  which  above  form  open  pouches,  and 
close  the  ventricle  against  the  pulmonary  artery,  as  they  lie  close  to  one  ano- 
ther, and  nodulus  Arantii  (a  thickening  in  the  centre  of  the  free  C-shaped 
margin  of  each  pouch),  also  shutting  the  triangular  space  yet  remaining  open. 

3.  Left  auricle,   dilatation  of  the  pulmonary  veins,  atrium  si?iistrum,  is 
placed  higher  than  the  right,  concealed  behind  Art.  pulmonalis,  Aorta,  and 
left  lung.    The  left  appendix,  longer  and  smaller  than  the  right,  is  placed  on 
the  anterior  surface,  close  to  Art.  pulmonalis,  and  its  conical  cavity  opens 
with  a  circular  mouth  into  the  auricle.     The  cavity  of  the  left  auricle  is  nar- 
rower than  the  right,  and  presents,  (besides  the  foramen  ovale  and  the  ostium 
venosum)  at  its  upper  part  the  four  mouths  of  the  pulmonary  veins,  two  on 
either  side. 

4.  Left  ventricle,  Aortic  ventricle,  ventriculus  sinister,  is  situated  further 
behind  than  the  right,  towards  the  left  and  above,  is  conical  (the  right  being 
pyramidal),  convex,  its  cavity  oval;  the  apex  reaches  farther  down;   the 
walls  are  three  to  four  times  thicker ;  two  openings. 

a.  Ostium  venosum,  between  auricle  and  ventricle  ;  elliptical,  large  (quite 
close  to  the  following  opening,  external  to  it,  so  that  the  valves  of  the  two 
meet  together),  is  closed  by  a  two-curtained  valve,  Jiyxo%ivt;,  valvula  Mi- 
tralis.     The  tendinous  cords  (chordae  tetidineai)  are  attached  to  the  borders  of 
the  valve,  and  are  stronger  than  in  the  right  ventricle. 

b.  Ostium  aorticum  is  of  the  same  character  as  the  arterial  opening  in  the 
right  ventricle,  closed  by  valvv.  semilunares  [more  developed] . 

Situation.  The  heart  lies  for  the  most  part  in  the  left  half  of  the  chest, 
one  inch  to  an  inch  and  a  half  to  the  right,  and  three  to  three  inches  and  a 
half  to  the  left  of  the  central  line  (in  the  Embryo  up  to  the  third  month  verti- 
cal); its  highest  point  (the  left  auricle)  corresponds  to  the  fifth  dorsal  vertebra ; 
its  deepest  part  (the  inferior  border  of  the  right  heart)  to  the  ninth  to  tenth 
dorsal  vertebra ;  the  apex  to  the  space  between  the  fifth  and  sixth  rib  carti- 
lage ;  the  mouth  of  the  pulmonary  artery  to  the  third,  that  of  the  Aorta  to 
the  space  between  the  third  and  fourth  left  rib  cartilage,  close  to  the  border 
of  the  Sternum.  Behind  the  Sternum  and  the  pericardium  we  meet  in  the 
following  order  from  before  backwards  with:  1.  the  right  ventricle;  2.  the 
pulmonary  artery ;  3.  the  right  auricle ;  4.  the  left  ventricle ;  5.  the  aorta ; 


THE  VESSELS.  293 

6.  the  left  appendix;  7.  the  right  auricle;  8.  the  superior  cava;  9.  the  left 
auricle  ;  10.  the  pulmonary  veins  (Blandin). 

Structure.  The  chief  mass  of  the  heart  consists  of  round  and  flat  muscular 
bands  (transversely  striated  fibres),  which  are  throughout  separated  into  two 
halves,  lying  evenly  close  to  one  another  on  the  outer  surface,  projecting 
irregularly  on  the  inside  of  the  cavity,  as  they  are  either  firmly  attached  at 
both  extremities  (fleshy  bands,  trabecula  carnece  [musculi  pectinati} ),  or  the 
free  pointed  extremity  is  turned  to  the  basis  of  the  heart  (mm.  papillares  [car- 
no;  columns] ).  In  the  ventricles  the  muscular  layer  is  as  thick  as  eight  lines ; 
at  places  in  the  ventricles  extremely  thin.  Fibro-cartilaginous  filaments  se- 
parate the  auricles  as  well  as  the  ventricles  (in  the  septa)  from  one  another, 
and  the  auricles  from  the  ventricles  (in  the  circular  groove).  The  outer  cover- 
ing is  formed  from  the  internal  layer  of  the  pericardium,  and  attached  by 
fibro-cellular.  containing  adipose  tissue.  Fat  is  found,  particularly  in  aged 
(also  in  lean)  individuals  on  both  sides  of  the  transverse  groove,  and  along  the 
coronary  vessels  as  far  as  the  apex,  especially  on  the  right  half  of  the  heart. 
The  internal  membrane,  endocardium,  the  immediate  continuation  of  the  in- 
ternal coat  of  the  large  venous  trunks,  lines  the  cavities  of  the  auricles  and 
ventricles,  forms  folds  at  the  passage  into  the  latter  and  in  the  great  arterial 
trunks,  between  which  two  layers,  areolar  tissue,  and  fibro-cartilaginous  fila- 
ments, are  found. 

These  folds  projecting  into  the  cavities  are  the 

Valves,  which  are  free  in  the  mouths  of  the  arteries  (as  valvv.semilunares), 
in  the  mouths  of  the  ventricles  (as  valv.  bi-  and  tricuspidates),  are  connected 
by  tendinous  filaments  with  the  muse,  pectin,  and  column,  carnece. 

The  internal  membrane  of  the  heart  is  thickest  in  the  auricles. 

Thickness  of  the  walls : 

Left  ventricle,  in  male,  5yy  Par.  lin. ;  female,  4£ 

Septum  of  ventricles      —       5         —  —       4i 

Of  right  ventricle  —       2         —  —       IT 

The  cavities  and  openings  of  the  right  half  of  the  heart  are  wider  than  those 
of  the  left. 

529.  Vessels  and  nerves  of  the  Heart. 

Arteries  :  coronaria  cordis  dextra  and  sinislra  from  aorta  ascendens. 

Veins  :  coronaria  cordis  magna  and  media. 

Lymphatics  :  accompany  the  arteries  and  pass  into  the  lymphatic  glands 

above  and  behind  the  areas  aortas. 
Nerves  :  plexus  coronarii  accompany  the  arteries  and  are  then  lost  in  the 

tissue  of  the  heart,  arising  from  plex.  cardiacus  magnus,  and  these  from 

Nn.  cardiaci  of  N.  Vagus  and  sympathicus. 

530.  The  Pericardium, 

is  a  fibro-serous,  perfectly  closed  sac,  in  which  the  heart  has  been  so  inverted 
that  it  is  wrapped  round  as  far  as  its  base,  and  is  covered  with  a  serous  mem- 


294  SPECIAL  ANATOMY. 

brane  firmly  attached  to  it.  The  heart  lies  also  on  the  surface,  not  in  the  ca- 
vity of  the  sac,  and  is  loosely  surrounded  by  the  non-inverted  portion  of  the 
pericardium,  so  that  it  can  move  freely  therein.  The  inverted,  internal  layer 
of  the  pericardium  passes  over  the  base  of  the  heart,  since  it  leaves  uncovered 
a  narrow  stripe  only  of  the  left  auricle,  on  the  great  vessels  (ven.  cava  super., 
aorta  and  Art.  pulmonal.)  into  the  free,  external  layer,  and  surrounds  the  ves- 
sels like  a  sheath.  To  the  external  surface  of  the  free  layer  we  find  a  thin 
fibrous  lamina  firmly  attached,  which  at  the  anterior  inferior  part  is  united 
with  the  tendon  of  the  diaphragm  (three  and  a  half  inches  transversely,  one 
to  two  inches  from  before  to  behind,  close  to  the  Sternum)  and  also  passes 
over  upon  the  vascular  trunks.  The  cavity  of  the  pericardium  secretes  a 
humid  vapour,  which  in  disease,  or  after  death,  becomes  fluid,  as  lig.  Peri- 
cardii;  its  walls  are  smooth. 

The  shape  of  the  pericardium  is  a  cone,  the  base  of  which  lies  upon  the 
speculum  Helmoutii,  of  the  diaphragm,  the  apex  looking  upwards  (to  the 
great  vessels).  Its  anterior  surface  is  covered  by  pleura,  and  touches  the 
sternum  with  only  a  small  rhomboidal  piece  covered  by  areolar  tissue  (cor- 
responding to  the  right  half  of  the  heart).  The  posterior  surface  is  separated 
from  the  vertebral  column  by  the  mediastin.  post,  with  oesophagus,  Aorta, 
duct,  thoracic.,  &c.  At  the  sides  the  Nn.  phrenici  and  Artt.  phrenic,  sup.  pass 
between  pericardium  and  pleura. 

Vessels:  Artt.  pericardiacce ,  or  branches  of  aorta  descend.,  mammar.  in- 
tern., phreniccB  super.,  bronchioles,  thymicce  and  cesophagece. 

Veins :  pass  with  the  arteries,  and  open  partly  into  Ven.  azygos. 

Lymphatics :  go  to  the  glands  on  the  V.  cava  superior,  and  into  the  due- 
tus  thoracicus. 

Nerves :  have  not  hitherto  been  found. 

531.  Circulation,  course  of  the  blood,  Circulatio  sanguinis, 

differs  according  as  to  whether  the  lungs  (after  birth)  effect  the  change  of 
the  dark  red  blood  into  the  bright  red,  or  the  placenta  (before  birth)  is  the 
medium  for  the  exchange  of  the  consumed,  for  a  blood  containing  nutritious 
substances. 

532.  I.  Circulation  after  birth. 

It  is  divided  into  two  sections  : 

1.  Smaller  circulation,  course  of  the  pulmonary  blood. — The  venous  blood 
collects  from  the  vv.  cavce  and  coronarice  cordis  in  the  right  auricle  of  the 
heart,  passes  into  the  right  ventricle,  thence  into  the  pulmonary  artery  and 
lungs.     From  the  capillary  rete  of  the  lungs  it  comes  forth  as  arterial  blood, 
and  returns  through   the  pulmonary  veins  to  the  heart,   but   to   the   left 
auricle. 

2.  Greater  circulation,  course  of  the  blood  through  the  body. —  Pressed  by 
the  left  auricle  into  the  left  ventricle,  thence  into  the  aorta,  the  bright  red 
blood  streams  through  all  arteries  (with  the  exception  of  the  pulmonary), 


THE  VESSELS.  295 

becomes  changed  into  the  dark  red  blood  in  the  capillary  rete  of  the  body  (in 
opposition  to  the  lungs),  passes  through  the  veins  (with  the  exception  of  the 
pulmonary)  and  returns  through  the  vv.  caves  and  coronaries  cordis  (see  before) 
to  the  right  auricle. 

533.  II.  Circulation  of  the  mature  foetus. 

1.  From  the  right  auricle  the  blood  passes  out,  a.  of  v.  cava  inf.  through 
the  foram.  ovale  (partly)  into  the  left  auricle  (partly  into  the  right  ventricle), 
hence  into  the  left  ventricle,  aorta  ascendens,  truncus  anonymus,  carotis  and 
subclavia;  b.  the  blood  of  v.  cava  superior  into  the  right  ventricle,  art.  pul- 
monalis and  through  the  ductus  arteriosus  Botalli  into  the  aorta  descend,  (in 
great  part)  into  two  artt.  umbilicales  and  in  these  through  the  umbilical  cord 
into  the  placenta. 

2.  From  the  Placenta  the  blood  passes  back  through  the  vena  umbilicalis 
into  the  belly  of  the  foetus ;  goes  along  through  a  branch  of  v.  umbilicalis  to 
the  ven.  porta,  through  another,  ductus  venosus  Arantii,  to  the  v.  cava  infer. 
into  which  also  the  blood  of  the  liver  and  of  the  inferior  half  of  the  body  empties 
itself. 

534.  A.   The  vessels  of  the  small  circulation, 

namely,  Art.  pulmonalis,  which  carries  the  blood  from  the  right 
half  of  the  heart  (venous  blood)  into  the  lungs  ;  and 

Vencz  pulmonales,  which  carry  back  into  the  left  half  of  the 
heart  the  blood  which  having  passed  through  the  Art.  pulmonalis 
to  the  lungs  has  been  changed  into  arterial  blood  by  the  influence 
of  the  inspired  air. 

535.  1.  The  pulmonary  artery,  arteria pulmonalis  s.  venosa, 

arises  above  and  before  from  the  right  ventricle  (thirty-one  and  a  half  to 
twenty-nine  and  one  third  lines  wide),  is  situated  at  the  commencement  be- 
fore, then  to  the  left  of  the  aorta,  since  it  inclines  to  the  posterior  and  right 
concave  side  of  this,  between  the  auricles  of  the  heart,  afterwards  before  the 
left  auricle,  it  finally  divides  after  a  course  of  one  and  a  half  to  two  inches  into 
two  branches  which  embrace  the  arch  of  the  aorta,  enter  into  the  lungs,  and 
after  fine  ramifications,  anastomosing  with  the  Artt.  bronchioles,  they  form  a 
capillary  rete  round  about  the  vesicles  of  the  lungs,  from  which  the  pulmo- 
nary veins  arise. 

a.  The  right  branch,  sixteen  to  eighteen  lines  long,  and  larger  than  the  left, 
passes  away  towards  the  right  and  behind  aorta  ascendens  and  V.  cava  supe- 
rior, before  the  bronchus  dexter,  above  the  superior  right  pulmonary  vein,  and 
enters  with  three  branches  into  the  three  lobes  of  the  right  lung. 

b.  ThS  left  branch,  one  inch  long  and  narrower,  passes  away  to  the  left  and 
backwards,  before  the  aorta  descendens  and  bronchus  sinister  (separated  from 
the  last,  sometimes  by  art.  branch.) ;  above  the  left  superior  pulmonary  vein 
and  enters  with  two  branches  into  the  twro  lobes  of  the  left  lung,  where  the 
pulmonary  veins  are  situated  before  it. 


296  SPECIAL  ANATOMY. 

In  the  embryo,  a  canal,  ductus  arteriosus  Botalii  passes  upwards  obliquely 
to  the  left  from  the  place  where  the  pulmonary  artery  divides  into  its  two 
branches,  to  the  concavity  ofarcus  aortce,  opposite  to  the  art.  subdavia  sinis- 
tra,  which  at  a  later  period  changes  into  the  ligam.  arteriosum  (one  to  two 
lines  thick,  four  long). 

536.  II.  Pulmonary  veins,  four,  Vence  pulmonales  s.  arteriosce, 

arise  from  the  capillary  vessels  of  Art.  pulmonalis  and  Artt.  bronchioles,  pass 
out  at  the  roots  of  the  lungs  before  the  arterial  and  bronchial  branches,  two, 
as  well  as  from  the  right  (at  the  commencement  three),  as  from  the  left  lung, 
and  sink  inside  the  pericardium  behind  F.  cava  super,  on  the  right  side  and 
Art.  pulmonalis  on  the  left,  into  the  superior  part  of  the  left  auricle.  They 
possess  no  valves.  The  capacity  of  all  four  together,  is  inferior  to  that  of  the 
pulmonary  arteries. 

Vessels  of  the  large  circulation,  Arteries. 

537.  Arteria  Aorta,  the  great  artery  of  the  body, 

arises  above  and  before  from  the  left  ventricle  (between  septum 
ventricul.  and  valv.  mitralis),  where  its  root  (bulbus  aortce)  cor- 
responds to  the  three  semilunar  valves,  presents  internally  three 
pouch-shaped  expansions  (sinus  Valsalvce),  and  externally  three 
elevations  (tubera).  At  the  origin  circular  (in  the  male  thirty- 
one,  in  the  female  twenty-eight  Paris  lines  wide),  farther  on  ellip- 
tical, anteriorly  convex. 

538.  Course.    It  ascends  from  left  to  right  (aorta  ascendens), 
at  the  same  time  a  little  curved,  between  Art.  pulmon.  and  V.  cava 
superior.     It  now  bends   suddenly  backwards,  and  passes  almost 
horizontally  (above  the  ramus  dext.  art.  pulmonal.)  from  right  to 
left,  and  from  before  backwards,  to  the  left  side  of  the  third  dorsal 
vertebra  (arcus  aortce);  whence  it  descends,  after  another  curva- 
ture, vertically  on  the  left  side  of  the  vertebral  column,  through 
the  thorax  (aorta  descendens  thoracica),  and  in  the  abdomen  be- 
fore the  centre  of  the  bodies  of  the  vertebrae,  as  far  as  the  fourth 
lumbar  vertebra  (as  aorta  desc.  abdominalis).     Here  it  divides 
into  its  two  terminating  branches,  arterice  iliacce. 

539.  Aorta  ascendens,  the  ascending  Aorta, 

two  to  two  and  a  half  inches  long.  Position :  surrounded  by 
the  pericardium ;  below,  behind  Art.  pulmonalis,  which  winds 
like  a  screw  from  before  to  the  left ;  behind :  ramus  dexter  art. 
pulmonalis  ;  to  the  right  above  :  V.  cava  superior  ;  to  the  right 
below :  the  right  auricle. 


THE  VESSELS.  297 


Branches  : 


1.  Small  twigs  for  Art.pulmonalis  and  V.  cava  superior. 

2.  Art .  coronaria  cordis  dextra  cardiaca,  the  coronary  artery,  arises  from 
the  anterior  surface,  close  above  the  tuber  anterius  bulbus  aortce  ;  is 
thicker,  passes  away  behind  Art.  pulmonal.,  in  the  sulcus  transversus, 
on  the  right  half  of  the  heart  towards  the  right  and  behind,  and  then  in 
the  longitudinal  groove  as  far  as  the  apex  of  the  heart.    Branches :  for 
the  right  half  of  the  heart,  bulbus  aortas  and  Art.  pulmon. 

3.  Art.  coronaria.  cordis  sinistra,  arises  above  tuber  posterius ;  passes  off 
into  two  branches. 

a.  ramus  anterior  s.  descendens  on  the  anterior  surface  of  the  heart  in 
the  longitudinal  sulcus,  reaching  downwards  as  far  as  the  apex,  and 
sending  branches  to  the  right  and  left  ventricles. 

b.  Ramus  posterior  s.  circumflexus  passes  on  the  left  to  the  posterior 
surface  of  the  heart  in  the  sulcus  transversus,  and  sends  branches 
to  the  left  half  of  the  heart. 

540.  Arcus  Aorta,  the  arch  of  the  Aorta. 

Situation  :  oblique  from  before,  backwards,  and  from  right  to 
left  (one  and  a  half  to  one  inch  long). 

1.  On  the  anterior  and  left  side:  the  left  Pleura.  Nn.  Phre- 
nicus  and  vagus. 

2.  Behind  and  to  the  right :  the  trachea,  the  commencement 
of  bronchus  sinister,  the  oesophagus,  ductus  thoracicus  N.  recur- 
rens,  vertebral  column  and  lymphatic  glands. 

3.  The  highest  point   of  the    convexity  directed    upwards   is 
situated  about  ten  to  twelve  lines  below  manubrium  sterni. 

4.  The  concavity  is  placed  above :  ram.  dext.  Art.  pulmonalis, 
N.  recurrens  sinister,  bronchus  sinister,  lymphatic  glands. 

Branches  :  from  the  concavity  only  very  small  branches  to  the 
bronchi  (bronch.  superr.),  pericardium,  thymus  ;  from  the  con- 
vexity :  Art.  anonyma  [brachio-cepJialica~\,  art.  carotis  and  sub- 
clavia sinistra. 

1.  Anonyma  s.  truncus  anonymus  [s.  brackio-ceph.] ,  the  common  trunk  of 
Art.  carotis  and  subclavia  dextra,  is  thick  and  one  inch  (to  two)  long  ;  arises 
the  farthest  upwards,  to  the  right  and  before  from  the  aortic  arch  ;  is  situated 
behind  the  manubrium  sterni  and  vv.  jugular es  communes,  a  little  before,  then 
to  the  right  of  the  trachea;  it  describes  with  the  Carotis  sinistra  an  acute  an- 
gle.    Sometimes  also  the  Carotis  and  subclavia  sinistra,  or  even  both  carotides 
and  subclavice  arise  from  a  common  trunk. 

2.  Carotis  communis  sinistra,  arises  from  the  centre  of  arcus  aortce  to  the 


298  SPECIAL  ANATOMY. 

left  and  behind  the  anonyma,  is  longer  than  the  Carotis  communis  dextra,  and 
passes  obliquely  before  the  trachea  and  to  the  left  of  it  and  the  thyroid  gland. 
3.  Subclavia  sinistra,  arises  the  farthest  backwards  and  to  the  left,  from  the 
arcus  aortas,  is  longer,  rather  thicker,  and  ascends  in  a  rather  straighter  direc- 
tion than  the  subclavia  dextra,  to  the  left  and  externally. 

541.  A.  Carotis  communis,  the  common  carotid  artery. 

Origin :  the  right  arises  from  the  A.  anonymo,  the  left  close  to 
A.  subclav.  dextra ;  on  the  right  close  to  the  trachea.  The  left 
from  the  centre  of  arcus  aorta  itself.  Course  :  both  carotids  as- 
cend obliquely  upwards  and  outwards,  from  the  chest  into  the 
neck,  and  terminate  at  the-  superior  border  of  the  larynx  with 
an  enlargement,  so  that  they  diverge  from  below  (where  trachea 
and  oesophagus)  upwards  (where  larynx  and  pharynx  lie  between 
them). 

Situation  :  1.  In  the  chest. 

a.  The  right  Carotis  commences  only  very  shortly  before  the 
superior  border  of  the  Manubrium  sterni,  from  which  it  is  se- 
parated by  ven.  jugular,  comm.  sinistra. 

b.  The  left,  about  one  inch  before  its  exit,  lies  behind  V.  sub- 
clavia sinistr.,  mm.  sterno-hyoidei  and  thyreo'idei  and  sternum  ; 
before  trachea  and  oesophagus,  Artt.  subclavia  and  vertebr.  sinist. 

"2.  In  the  neck  :  in  a  sheath  offasc.  cervicalis  ;  the  inferior  half 
of  the  anterior  surface  covered  by  mm.  sterno-thyreoideus,  sterno- 
mastoideus ;  the  centre  by  the  tendons  and  the  superior  belly  of 
m.  omo-hyoideus  ;  the  superior  half  in  the  trigonum  cervicale  su~ 
perius  only  by  platysma-myoides.  The  posterior  surface  is  sepa- 
rated from  the  vertebral  column  by  mm.  rectus  capitis  and  long, 
colli,  and  (below)  Ven.  thyreoidea  inferior.  Internally  are  situated  : 
trachea,  (Esophagus,  larynx,  and  thyroid  gland.  Externally :  F. 
jugularis  interna.  Between  these  and  the  Carotis:  ram.  descend. 
N.  hypoglossi  (the  farthest  forwards),  N.  vagus  (inwards),  N. 
Sympathicus  (externally  and  behind).  The  first  passes  down- 
wards only  to  the  centre,  the  two  last  vertically  along  the  entire 
cervical  portion  of  the  carotis. 

Branches  pass  off  from  the  Carotis  communis  as  exceptions 
only,  as :  Art.  thyreoid  inf.  (and  media) ;  but  it  divides  into  two 
terminal  branches,  into  Carotis  externa  and  interna. 

542.  I.  Carotis  externa  s.facialis. 

Origin:  on  an  elevation  with  the  superior  border  of  the  larynx^ 
internal  to  and  before  Carotis  interna.  Termination  :  at  the  neck 
of  Condylus  mandibulce.  Course :  in  adult  slightly  undulating ; 


THE  VESSELS.  299 

in  the  trigonum  cervicale  superius  vertically  as  high  as  the  m.  di- 
gastricus :  then  backwards  and  outwards  as  far  as  the  angle  of 
the  inferior  jaw  ;  then  again  vertically  along  the  posterior  border 
of  ramus  mandibulce.  Circumference :  inferior  to  that  of  the 
carotis  internet,  (in  children) ;  length,  two  and  a  half  to  three  and 
a  half  inches.  Situation :  at  the  commencement  covered  by  V. 
facials  commun.j  and  platysmam.,  only ;  then  behind  mm.  di- 
gastricus  (the  posterior  belly),  and  stylo-hyoideus  (before  m.  stylo- 
glossus],  and  n.  hypoglossus  ;  lastly,  within  the  Parotis  (and  quite 
above  between  Parotis  and  lower  jaw). 

Collateral  branches ;  three  anterior :  A.  thyeoidea  super.,  lingua- 
lis  maxiUar.  extern,  s.facialis. 

2  Posterior :  Aa.  occipitalis  and  auricularis. 

1  Internal :  A.  pharyngea. 

2  Terminal  branches :  Artt.  temporalis  and  maxittar.  interna. 
The  three  anterior  and  the  internal  arise  below  the  m.  digastri- 

cus  ;  the  two  posterior  before  the  entrance  into  Parotis. 

543.     The  anterior  branches  of  the  Carotis  externa. 

1.  Thyreoidea  superior,  the  superior  thyroideal  artery  supplies  the  Larynx 
and  thyroid  gland  with  blood. 

Or. :  close  above  (sometimes  at)  the  point  of  division  of  the  carol,  commun. 
Course  :  at  first  upwards,  directly  afterwards  downwards,  several  times 
curved  to  the  superior  cornu  of  the  thyroid  gland.  Position :  at  first  only 
behind  the  skin,  then  behind  mm.  omo-,  sterno-,  kyoideus,  and  sterno-thy- 
reoideus. 

Branches : 

a.  Art.  laryngea  superior,  the  superior  laryngeal  artery,  arises,  sometimes, 
from  the  carotis  externa.     Course  :  transverse  between  m.  hyo-thyreoid. 
and  memb.  hyo-thyreoid,  perforates  the  last  (with  N.  laryng.  sup.}  gives  a 
superior  branch  to  the  Epiglottis  and  a  descending  for  m.  thyreo-aryta- 
noid,  and  the  mucous  membrane. 

b.  Art.  laryngea  inf.  s.  ram.  cricothyreoideus  (Cruveilhier),  arises  from  the 
internal  terminal  branch,  passes  transversely  on  the  inferior  border  of  the 
thyroid  cartilage,  anastomoses  with  that  of  the  other  side,  and  ramifies  on 
the  mucous  membrane  and  the  muscles  of  the  larynx. 

c.  Ram.  sterno-mastoideus,  arises  under  a,  and  passes  away  downwards 
over  carotis  communis  on  the  posterior  surface  of  m.  sterno-cleido-mas- 
toideus. 

d.  Rami  thyreoidei,  three  terminal  branches.  The  first  passes  between  thy- 
roid gland  and  trachea,  the  second  along  the  external  border,  the  third  in 
the  central  line  before  the  thyroid  gland. 

2.  Lingualis,  the  lingual  artery.     Origin :  on  a  plane  with  the  great  cornu 


300  SPECIAL  ANATOMY. 

of  the  os  hyoides.  Course :  obliquely  upwards,  then  along  the  superior 
border  of  the  hyoid  bone,  forwards  and  inwards,  and  thence  into  muscles  of 
the  tongue  from  behind  forwards.  Termination :  at  the  tip  of  the  tongue  as 
Art.  ranina.  Position :  commences  below  m.  digastricus,  stylo-hyoid,  and 
n.  hypoglossus;  on  the  os  hyoides  between  m.  hyogloss.  and  constrictor  pha- 
ryng.  medius;  in  the  tongue  between  m.  genioglossus  and  lingualis  (close  to 
n.  lingualis.) 

Branches : 

a.  Earn,  hyoideus,  passes  away  transversely  above  the  hyoid  bone,  anas- 
tomoses with  that  of  the  other  side,  between  m.  genio-glossus  and  genio- 
hyoideus. 

b.  Art.  dorsalis  lingua,  small,  arises  on  a  plane  with  the   cornu  majus  oss. 
hyoid,  passes  upwards  to  the  border  of  the  tongue  and  to  arcus  glosso- 
palatinus,  forwards  and  inwards,  always  close  under  the  mucous  mem- 
brane, gives  branches  to  the  epiglottis,  mm.  hyo-,  aindstylo-glossus;  lastly, 
the  skin  in  the  region  of  papilla  calyciformes. 

c.  Art.  sublingualis,  stronger  than  the  former,  passes  between  m.  mylo- 
hyoideus  and  the  mucous  membrane,  upon  the  floor  of  the  mouth  forwards, 
along  the  inferior  border  of  glandul.  sublingual.,  external  to  the  duct. 
Wliartonianus,  supplies  these  parts,  and  terminates  with  a  branch  above 
thefrenulum  and  a  branch  for  the  foramina  incisiva  at  the  chin. 

d.  Art.  ranina  s.  profunda,  the  terminal  branch,  penetrates  above  into  the 
thickness  of  the  tongue,  between  m.  geniogloss.  and  lingualis  (half  an 
inch  distant  from  the  back  of  the  tongue),  and  runs  along  to  the  tip,  as 
it  gives  off  internal,  external,  and  superior  branches  for  the  muscles  and 
papillae. 

3.  Maxillaris  externa,  s.  facialis. — large.  Or.  :  rather  higher  than  lin- 
gualis, covered  by  m.  digastric,  and  stylohyoideus.  Course  :  very  serpentine  ; 
at  first  upwards  to  the  angle  of  the  lower  jaw,  then  horizontally  forwards  in 
the  fossa  on  the  outer  surface  of  gland,  submaxillaris;  towards  the  middle  of 
the  horizontal  ramus  of  the  lower  jaw  it  turns  over  it  into  the  face,  passes  ob- 
liquely upwards  to  the  mouth,  nose,  and  internal  angle  of  the  eye,  and  anas- 
tomoses with  Artt.  ophthalmica  and  infraorbitalis.  Position:  at  first  be- 
tween gland,  submaxill.  andparotis,  along  the  basis  of  the  lower  jaw:  exter- 
nally the  skin  and  lymphatic  glands,  internally  the  gland,  submaxillaris;  in 
the  face  on  the  anterior  border  of  m.  masseter,  below  covered  by  the  skin 
(with  m.  risorius),  above  the  angle  of  the  mouth  by  the  zygomatici  and  leva- 
tores  labii,  lastly,  by  much  fat  and  skin. 

544.  Branches  of  the  horizontal  portion. 

a.  Art.  Palatina  ascendens  (arises  sometimes  from  Corot.  externa  or  pha- 
ryngea  ascendens),  ascends  behind  mm.  styloidei,  to  the  side  of  the  pharynx, 
ramifies  in  the  Tonsils  (Art.  tonsillaris),  the  soft  palate  and  its  arches,  anas- 
tomoses with  A.  pharyngea  ascendens. 


THE  VESSELS.  301 

b.  Art.  submentalis  passes  directly  forwards,  along  the  (internal)  inferior 
border  of  the  lower  jaw,  between  mm.  mylohoid.  and  digastricus,  inclines  on 
the  external  border  of  the  last  (vent,  anter.)  upwards,  supplies  the  skin  and 
muscles  of  the  chin,  and  anastomoses  with  branches  of  A.  dentalis  inferior 
and  sublingualis. 

c.  Kami  glandulares,  3.  and  4.  small,  supplies  gl.  submaxillar. 

d.  Ramus  pterygoideus,  small,  for  m.  pteryg.  internus. 

Branches  in  the  face.    a.  External,  supplying  the  muscles  and  skin  of  the 
cheek ;  the  most  distinct  are,  ram.  massetericus  and  buccinatorius. 
b.  Internal. 

1.  Art.  coronaria  8.  labialis  inferior,  arises  close  under  the  angle  of  the 
mouth,  passes  between  the  muscular  and  glandular  layer,  not  far  from 
the  free  edge  of  the  under  lip,  and  anastomoses  with  that  of  the  other  side. 

2.  Art.  coronaria  s.  labialis  superior,  arises  at  the  angle  of  the  mouth,  under 
m.  levator  labii  super.,  passes  to  the  upper  lip  like  1.,  and  gives  off  from 
the  middle  line : 

a.  Art.  septi  mobilis  nasi,  which  passes  to  the  cartilaginous  nasal  sep- 
tum, vertically  upwards,  and  then  horizontally  under  the  sept,  mobile. 

b.  Art.  pinnalis  s.  alaris  nasi,  at  the  posterior  border  of  the  nasal  open- 
ings, anastomoses  with : 

3.  Art.  angularis  B.  nasalis  lateralis,  passes  upwards  from  the  angle  of  the 
nose  to  the  internal  angle  of  the  eye,  and  there  unites  with  art.  ophthal- 
mica  in  the  art.frontalis.     It  gives  the  following  branches  : 

a.  Rami  pinnales,  1.  at  the  superior,  concave  border  of  the  nasal  pinna; 
2.  enters  into  the  nose. 

b.  Rami  dorsales,  on  the  back  of  the  nose. 

c.  Rami  palpeb rales,  on  the  inferior  eyelid. 

The  most  remarkable  anastomoses  of  Art.  maxillaris  externa  are  :  a.  with 
A.  dental,  inferior;  b.  with  A.  maxillar.  intern.;  c.  with  A.  ophthalmica. 

545.  The  posterior  branches  of  Carotis  externa. 

4.  Occipitalis,  the  occipital  artery, — smaller  than  1.  and  3.     Origin:  Art. 
maxillar.  extern,  or  lingualis,  opposite,  sometimes  close  under,  the  Parotis; 
covered  by  m.  digastricus  and  IV.  hypoglossus.    Course :   oblique  upwards 
and  backwards,  above  proc.  transv.  atlantis,  under  incisura  mastoid.  horizon- 
tally backwards,  very  tortuous.     Position :  deep,  separated  in  front  by  m. 
stylohyoid.  from  art.  auricular,  post,  and  carot.  externa.     The  horizontal  por- 
tion between  m.  rectus  lateral,  and  complexus,  then  between  obliquus  super. 
and  splenius.    Divided  under  m.  splenius  into  an  external  and  an  internal  as- 
cending branch. 

Collateral  branches  :  a.  rami  cervicales  consist  of:  1.  for  TO.  sterno-cleidom.; 
enters  at  the  internal  surface  into  the  superior  part  of  the  muscle,  turns  round 
the  loop  of  the  n.  hypoglossus.  2.  Earn,  descendens,  between  m.  splenius  and 
complexus,  divides  among  the  superior  layers  of  the  cervical  muscles  (m.  splen., 


302  SPECIAL  ANATOMY. 

trachelomast.,  complex.,  biventer  cervicis ,  cucullaris),  and  in  the  deeper  (mm. 
recti  and  obliqui). 

b.  Art.  stylomastoidea  (s.  Art .  auricular,  post.} 

c.  Art.  meningea  posterior  s,  mastoidea,  enters  through  foram.  mastoideum 
(or/,  occipitale)  for  the  posterior  part  of  the  dura  mater. 

d.  Ram.  parietalis — frequently,  enters  through  for.  parietales  to  sin.  longi- 
tud.  superior.    The  two  ascending  terminal  branches  reach  as  far  forward  as 
the  vertex,  and  are  situated  between  galea  aponeurotica  and  the  skin. 

5.  Auricularis  posterior,  the  posterior  auricular  artery,  supplies  the  external 
and  internal  ear,  the  Parotis,  narrower  than  four,  arises  sometimes  in  common 
with  it  or  from  it,  generally  one  inch  high  above  it.     Course :  upwards,  in 
the  direction  of  and  external  to  proc.  styloid.  at  first  behind  and  between  m. 
digastric,  and  parents;  then  covered  by  retrahentes  auricula,  and  divides  at 
the  anterior  border  oiproc.  mastoideus  into  two  branches,  ram.  mastoideus  and 
auricularis. 

Collateral  branches  :  a.  Eamimusculares  for  sterno-cleidom.,  digastric.,  sty- 
lo-hyoideus  and  glossus. 

b.  jK.  glandulares  for  the  Parotis. 

c.  Art.  stylo-mastoidea,  enters  into  the  stylo-mastoid  foramen,  traverses 
the  canalis  Fallopice,  meets  with  a  branch  of  Art.  mening.  media  anastomosing 
at  hiatus  can.  Fallop.,  gives  branches  to  :  cellules  mastoid.,  Tympanum  (Art. 
tympanica  superior},  Memb.  tympani  (forming  on  this  with  a  branch  of  Art. 
temporalis  the  plexus  tympanicus),  and  to  the  cochlea  (through  fenestra  ro- 
tunda). 

Terminal  branches. 

d.  Eamus  occipitalis  s.  mastoideus  ascends  backwards  beneath  the  skin, 
passes  with  a  horizontal  branch  inwards  along  the  superior  border  of  m.  sterno- 
cleidom.  and  splenius;  with  an  ascending  to  the  external  border  of  m.  occipitalis 
as  far  as  the  vertex ;  supplies  mm.  retrahentes  and  skin  ;  anastomoses  with 
art.  temporal,  and  occipitalis. 

e.  Ram.  auricularis  s.  anterior,  passes  upon  the  posterior  surface  of  the  ex- 
ternal ear,  with  a  superior  and  an  inferior  branch  ;  the  last  supplies  the  lobule 
of  the  ear,  passes  in  the  groove  between  helix  and  anthelix,  as  it  perforates 
the  concha. 

6.  Pharyngea  adscendens,  the  ascending  pharyngeal  artery — the  smallest 
branch  ofcarotis  externa.     Or:  from  the  posterior  side  of  the  carot.  externa, 
close  above  the  place  of  division  of  carot.  communis;  or,  on  a  plane  with  A. 
lingual.     Course  and  position :  vertically  upwards,  at  first  between  carotis 
externa  and  interna,  then  behind  the  last  in  the  triangular  space  between  pha- 
rynx and  m.  pterygoideus  internus;  divides  into  two  branches,  art.  meningea 
post,  and  ram.  pharyngeus.      Collateral  branches :  ram.  pharyngeus  inferior, 
which  passes  transversely  inwards,  in  ascending  and  descending  branches,  and 
anastomoses  with  a.  thyreoid  inferior. 


THE  VESSELS.  303 

Terminal  branches. 

a.  Art.  meningea  posterior,  ramify  in  the  gangl.  suprem.  N.  sympathici,  Nn. 
vagus,  glossopharyng.,  hypoglossus,Sind  enters  through  fo ram.  jugulare  to  the 
dura  mater  in  the  fossa  occipital,  inferior;  gives  a  branch  which  anastomoses 
with  Art.  cervical,  adscend. 

b.  Earn,  pharyngeus,  continuation  ofpharyng.  ascend.     Course  :  before  the 
carotis  interna,  and  divides  at  the  basis  cranii,  behind  the  pharynx  into  seve- 
ral branches,  which  are  reflected  and  terminate  on  the  tuba  Eustachii,  and  in 
the  muscles  of  the  pharynx. 

546.        Terminal  branches  of  the  Carotis  externa. 

7.  Temporalis  (superficialis),  the  temporal  artery.  Origin :  behind  collum 
condyli  of  the  lower  jaw  and  before  the  external  auditory  meatus.  Course : 
directly  upwards,  before  the  ear,  over  the  root  of  the  process,  zygomatic.  of  the 
temporal  bone,  then  in  a  serpentine  direction  as  far  as  the  centre  of  the  tem- 
poral region  (or  one  inch  above  the  zygoma}  where  it  divides.  Position :  at 
first  upon  the  maxillary  articulation  covered  by  Parotis,  then  by  the  skin  and 
fasc.  parotidea,  only,  above  fascia  temporalis. 

Anterior  collateral  branches. 

a.  Transversafacei,  arises  (frequently  from  carotis  external  immediately  at 
the  collum  condyli,  passes  transversely  over  this  and  m.  masseter,  covered  by 
Parotis,  underneath  the  zygoma  (inch  and  a  half)  and  above  ductus  Stenonia- 
nus  (parallel  with  it)  on  to  the  face ;  sends  a  branch  for  the  maxillary  articu- 
lation, for  the  duct.  Stenon.,  several  r.  masseterici  and  ramifies  on  the  ante- 
rior border  of  m.  masseter  into  cutaneous  branches  for  the  cheeks  into  muscular 
branches  for  mm.  zygomaticus  major,  orbicular,  palebr.,  levat.  labii  super.; 
anastomoses  between  artt.  temporal,  and  buccalis,  infraorbital.  and  max- 
Ularis  externa. 

b.  Nam.  orbicularis,  not  always  present,  arises  above  the  zygoma,  placed 
behind  m.  orbicularis,  supplies  these  and  anastomoses  with  art.  palpebral. 
super,  (see  Art.  ophthalm.) 

Posterior  branch. 

c.  Auriculares  anteriores;  the  inferior  for  the  lobule  of  the  ear ;  the  central 
for  the  auditory  meatus ;  the  superior  for  helix,  m.  attrahens  and  attollens  au- 
ricula. 

Internal  branch. 

d.  Art.  temporalis  media  (a. prof  undo,),  arises  close  above  the  zygoma,  enters 
into  the  m.  temporal,  through  the  deep  layer  of  fasc.  temporal,  and  anastomoses 
with  the  temporal  artery  of  Art.  maxillaris  interna. 

Terminal  branches. 

e.  Earn,  frontalis  s.  anterior  passes  in  a  curve  towards  the  forehead,  and 
anastomoses  with  art.  frontalis,  supraorbital.  and  ram.  frontal,  of  the  other 
side. 


304  SPECIAL  ANATOMY. 

f.  Ram.  occipitalis  s.  parietalis,  larger,  passes  upwards  to  the  vertex  and 
anastomoses  with  Artt.  auricular.,  occipitalis  and  ram.frontalis. 

8.  Maxillaris  interna  (s.  facialis  pro/undo).  Origin :  behkid  the  collum 
condyli  of  the  lower  jaw.  Course :  horizontally  forwards,  inwards  and  rather 
upwards  to  the  tuber,  maxill.  super.,  curves  forwards  and  sinks  into  fossa 
spheno-maxillaris,  where  it  terminates  as  spheno-palatina.  Position  :  at  first 
close  behind  the  condylus  and  before  proc.  styloideus;  between  mm.  pterygoid. 
extern,  and  internus  (external  to  n.  dentalis  and  lingualis),  then  between 
pterygoid.  extern,  and  temporalis. 

547.   Collateral  branches  :  A.  Arising  in  the  neighbourhood 
of  the  Collum  condyli. 

a.  Auricularis  profunda  ascends  directly,  divides  into  branches  for  the 
maxillary  articulation,  the  external  auditory  meatus  (through  some  foramina 
in  the  bones)  and  the  inferior  border  of  the  memb.  tympani. 

b.  Tympanica  (inferior),  the  tympanic  artery,  frequently  from  Art.  tempo- 
ralis, small ;  supplies  the  external  auditory  meatus,  the  maxill.  articulation, 
and  enters  through  fissura  Glaseri  into  the  tympanum,  on  the  anterior  wall  of 
which  and  the  memb.  tympani  it  anastomoses  with  tympanica  superior  (s. 
stylo-mastoid). 

c.  Meningea  media  s.  spinosa,  ascends  vertically  behind  collum  condyli  and 
m.  pterygoid.  extern,  through  foram.  spinosum  into  the  cranium,  becomes 
horizontal  and  is  placed,  divided  into  an  anterior  and  posterior  branch,  be- 
tween dura  mater  and  the  bones  of  the  skull;  the  anterior  ramus  ascends  from 
the  inferior  angle  towards  the  external  angle  of  the  fiss.  orbital,  super.,  and 
thence  as  far  upwards  as  the  sagittal  suture  ;  the  posterior  ramus  ascends  on 
the  pars  mastoid.  of  the  temporal  bone  as  far  as  the  posterior  inferior  angle  of 
the  parietal  bone,  and  as  high  as  the  sagittal  suture.     Small  ramuli  pass  out 
of  the  skull. 

1.  Eamul.  petrosus,  through  hiatus  into  canal.   Fallopia   to   the  nerv. 
facialis  and  Art.  stylomastoid. 

2.  Ramuli  for  nerv.  trigeminus. 

3u  Ramul.  for  m.  mallei  intern,  through  the  semi-canal  for  this. 
4.  Rami  temporales  for  the  great  wing  of  the  sphenoid  bone,  anastomoses 
with  the  Artt.  temporales  profundtB. 

d.  Dentalis  s.  alveolaris  inferior,  arises  close  to  the  last  artery,  passes  down- 
wards and  between  m.  pterygoid.  intern,  (or  rather  lig.  maxillare  intern.)  and 
the  ramus  of  the  lower  jaw  through  foram.  maxillar.  posterius,  and  passes 
through  the  canal,  alveolar,  infer,  as  it  gives  off  a  twig  in  the  interior  of  this 
to  each  tooth,  and  many  small  ones  for  the  diploe  of  each  alveolus.    Art.  my- 
lohyoidea  passes  from  foram.  max.  post,  to  the  inner  surface  of  ramus  maxillar. 
in  a  groove  with  nerv.  mylohyoid  downwards  to  m.  mylohyoid.  Through  foram. 
mentale  a  larger  branch  passes  out  as  art.  mentalis  from  the  canal,  and  anas- 
tomoses with  art.  submentalis  and  coronar.  inferior. 

e.  Temporalis  profunda  posterior  passes  between  m.  pterygoid.  extern,  and 


THE  VESSELS.  305 

temporal,  upwards,  to  the  posterior  border  of  the  last,  and  ramifies  in  these 
and  the  periosteum  ;  anastomosing  with  Artt.  temporal,  profund.  anter.  and 
media,  and  gives,  sometimes,  Artt.  masseterica  and  buccinatoria. 

f.  Masseterica,  small,  passes  over  incisura  semilunar.  outwards  to  the  mas- 
seter  m. 

g.  PterygoidecB  for  mm.  pterygoidei;  some  from  the  Art.  c.  and  e. ;  ptery- 
goid.  extern,  gives  off,  sometimes,  a  meningea  parva  through  foram.  ovale. 

548.      B.  Arising  in  the  neighbourhood  of  the  tuber 
Maxillce  super'ioris. 

h.  Buccinatoria,  small,  passes  in  a  serpentine  course  from  behind  forwards, 
between  the  ramus  of  the  lower  jaw  and  m.  plerygoid.  intern.,  and  is  lost  inm. 
buccinatorius. 

i.  Temporalis  profunda  anterior,  passes  to  the  anterior  border  of  m.  tempo- 
ralis  (behind  the  malar -sphenoidal  suture)  upwards,  is  lost  in  the  last,  and 
sends  branches  into  the  fat  of  the  orbit. 

k.  Dentalis  superior  (posterior)  passes  downwards  in  a  very  serpentine 
manner  to  the  posterior  surface  of  the  upper  jaw,  below  proc.  zygomat.  upon 
the  anterior  surface  of  the  former,  gives  branches  to  the  gums,  periosteum, 
and  the  superior  alveolus,  and  enters,  divided  into  several  branches,  through 
foramm.  alveolaria  postt.  into  the  upper  jaw  for  the  (superior)  molar  teeth. 
Separate  branches  pass  to  the  mucous  membrane  of  the  antrum. 

1.  Infraorbitalis,  arises  behind  fissura  orbital,  infer.,  and  enters  immedi- 
ately into  the  canal,  infraorbitalis,  passes  through  it,  and  appears  at  its  ante- 
rior opening  on  the  face,  where  the  artery  ramifies  in  branches  for  the  exte- 
rior and  mucous  membrane  of  the  cheeks,  gums,  the  corner  and  incisor  teeth, 
and  for  the  nose,  and  anastomose  with  Artt.  maxillaris  externa  and  facialis 
transversi. 

Branches  out  ofcanalis  infraorbitalis. 

1.  Earn,  orbitalis,  passes  with  a  branch  forwards  to  the  inferior  eyelid ; 
with  another  inwards  for  ram.  palpebral.  infer,  of  art.  ophthalm. 

2.  Ram.   dentalis  anterior,  passes  downwards  between  the  plates  of  the 
upper  jaw  (anterior  wall)  to  the  roots  of  the  cuspids  and  incisor  teeth. 

549.         C.  Arising  in  \hefossa  spheno-maxillaris. 
m.   Vidiana,  passes  backwards  through  canal  Vidianus  to  the  superior  wall 
of  the  pharynx  and  to  the  tuba  Eustachii;  arises  also  from  the  following  (as 
pharyngea  supremo). 

n.  Pterygo-palatina  s.  palatina  superior,  internal  and  below  the  former,  de- 
scends through  can.  pterygo-palatinus  behind  the  upper  jaw,  through  and  out 
of  foram.  palati.  anterius  [postering]  and  passes  in  a  serpentine  course  close 
to  the  alveolus  forwards  on  the  inferior  surface  of  the  palatine  vault,  until, 
forming  a  curve,  it  meets  with  the  one  of  the  other  side  at  theomai.  incisivut. 
Quite  above  it  gives  off 

1.  Ramuli palatini;  going  through  canales  palatinipost.  to  the  soft  palate. 

20 


306  SPECIAL  ANATOMY. 

2.  Branches  for  the  glands  and  mucous  membrane  of  the  palatine  vault. 

3.  Ram.  nasalis  enters  through  can.  palatinus  anter.  into  the  nasal  cavity. 
o.  Art.  spheno-palatina  s.  nasalis  posterior,  the   terminal  branch  of  Art. 

maxill.  intern.,  passes,  curved,  transversely  inwards  through  foram.  spheno-pa- 
latinum  into  the  nasal  cavity,  and  divides  behind  the  superior  nasal  chamber 
into: 

1.  Art.  septi  narium  8.  nasopalatina,  which  passing  obliquely  inwards, 
downwards,  and  forwards,  between  the  nasal  septum  and  mucous  mem- 
brane, it  divides  into  a  superior  and  inferior  branch,  and  anastomoses 
with  art.  palat.  super,  in  the  canalis  incisivus. 

2.  Art.  nasalis  posterior,  enters  behind  the  middle  concha  into  the  nose, 
descends  upon  the  internal  surface  of  the  palate  bone  forwards,  perfo- 
rates the  inferior  concha,  and  enters  the  inferior  nasal  chamber. 

3.  Art.  pharyngea  descendens  passes  in  a  canal  (internal  to  vidian)  at  the 
base  of  proc.  pterygoid.  backwards  to  the  superior  part  of  the  nasal 
cavity  and  the  pharynx. 

Art.  maxillaris  interna,  thus  sends  branches  : 

1.  To  the  organs  of  mastication,  as  :  Artt.  dentales,  infraorbitalis;  masse- 
terica,  temporal,  profunda  ant.  and  post,  pterygoidea. 

2.  To  the  organs  of  deglutition :   Artt.  palatina  super.,   vidiana,  pha- 
ryngea. 

3.  To  the  cavities  of  the  nose  :  Artt.  infraorbitalis,  spheno-palatina. 

4.  To  the  organs  of  audition  :  Art.  tympanica,  auricularis  prof.,  rami  art. 
meningece  mediae. 

5.  To  the  face  :  Artt.  buccinatoria,  infraorbitalis,  mentalis. 

6.  To  the  cranial  cavity :  Art.  meningea  media. 

550.      II.  Carotis  interna  s.  Cerebralis,  the  internal 
Cranial  Artery. 

It  supplies  the  anterior  portion  of  the  brain  and  the  eye.  Course  : 
from  the  point  of  separation  of  the  carotis  communis  as  high  as 
the  m.  digastricus  (posterior  belly),  almost  parallel  with  carotis 
externa  and  a  little  curved  ;  "thence  to  the  entrance  into  the  canal, 
caroticus  deeper  backwards  and  inwards,  in  a  triangular  space  be- 
tween pharynx  and  ram.  maxill.  infer. ;  before  the  entrance  ho- 
rizontal. In  the  canal,  caroticus  it  makes  four  curvatures,  as  at 
first  it  ascends  vertically,  then  passes  (first  curve)  horizontally  for- 
wards and  inwards  as  far  as  sinus  cavernosus  to  the  apex  of  the 
temporal  bone,  comes  forth  and  (second  curve)  ascends  at  a  right 
angle  by  the  side  of  sella  turcica,  passes  again  horizontally  (third 
curve)  as  far  as  proc.  clinoid.  anter.,  and  (fourth  curve)  perforates 
the  dura  Mater  obliquely  upwards,  backwards,  and  somewhat  in- 
wards, on  the  outer  side  of  the  optic  nerves.  Situation :  in  the 


THE  VESSELS.  307 

neck,  behind  mm.  stylo-glossus  and  pharyngeus,  separated  by 
these  from  carotis  externa  ;  before  m.  longus  colli  and  the  verte- 
bral column ;  internally,  bounded  by  the  lateral  wall  of  the  pha- 
rynx, art.  pharyngea  ascend,  and  gangl.  -I.  N.  sympathici,  exter- 
nally by  the  ramus  of  the  lower  jaw,  V.jugularis  internet,  and 
Nn.  vagus,  glosso-pharyng.,  hypo-glossus  (which  lie  behind  it 
above) ;  in  the  canal,  caroticus :  surrounded  by  filaments  from 
ganglion  cervicale  supremum  and  by  a  thin  sheath ;  in  the  sinus 
cavernosus :  on  the  inner  side  of  nerv.  abducens,  oculo-mot.,  pa- 
thetic., and  ram.  ophthalm.  of  the  fifth  nerve. 

Branches  :  As  an  exception,  the  Artt. pharyngea  ascendens  and 
temporalis  pass  off  from  the  cervical  portion,  otherwise  none ;  in- 
side the  canal,  caroticus  a  small  branch  for  the  tympanum  ;  in 
the  sinus  cavernosus  several  small  branches  for  the  basilar  portion 
of  the  dura  mater,  the  walls  of  sinus  petrosus  infer.,  for  the  hy- 
pophysis cerebri,  N.  trigeminus,  and  a  connecting  branch  to  the 
Art.  mening.  media.  Besides,  anteriorly  :  Art.  ophthalmica,  and 
the  terminal  branch  of  carotis  interna  ;  these  are,  artt.  communi- 
cans,  choroidea,  corporis  callosi,  fossce  Sylvii. 

551.  1.  Ophtkalmica. — Origin:  close  behind  proc.  clinoid.  anter.  from 
the  convex  anterior  surface  of  the  fourth  curve  of  the  carotis.  Course  :  en- 
ters immediately  below  the  optic  nerve,  through  the  foram.  opticum  into  the 
orbit,  passes  at  first  on  the  outer  and  lower  side  of  the  optic  nerve,  between 
muse,  rectus  super,  and  externus,  then  inwards  above  n.  opticus  as  far  as  the 
internal  wall  of  the  orbita  ;  lastly,  directly  forwards  along  the  inferior  border 
of  obliq.  superior,  and  under  the  trochlea,  and  divides  at  the  place  of  junction 
of  the  upper  jaw  and  frontal  bone,  into  Art.  nasalis  andfrontalis. 

Collateral  branches  :     Arising  on  the  outer  side  of  the 
Nervus  Opticus. 

a.  Lacrymalis,  the  lacrymal  artery,  large,  arises  immediately  as  the  Art. 
ophthal.  enter  the  orbita  (or  as  it  crosses  the  optic  nerve),  passes  on  the  exter- 
nal wall  between  periorbita  and  m.  rect.  extern.,  as  far  as  the  lacrymal  gland, 
ramifies  here  and  gives  off  branches  to  the  superior  eyelid,  m.  rect.  extern., 
super.,  to  Art.  mening.  med.  (backwards),  to  the  temporal  (through  for.  zygo- 
matic.) 

b.  Centralis  retinas,  thin ;  penetrates  into  the  centre  at  the  inferior  side  of 
the  optic  nerve,  passes  in  its  axis  directly  forwards,  spreads  out  with  three 
diverging  branches  on  the  internal  surface  of  the  retina.    A  branch  passes 
from  it  in  the  axis  of  the  eye  ;  this  is, 

Capsularis,  through  the  vitreous  body  as  far  as  the  posterior  wall  of  the 
capsule  of  the  lens,  giving  off  on  the  way  minute  ramusculi. 


308  SPECIAL  ANATOMY. 

Arising  above  the  Optic  Nerve. 

c.  Supraorbitalis,  arises  where  the  ophthalmic  artery  crosses  the  optic 
nerve,  passes  between  the  roof  of  the  orbita  and  m.  levatorpalpebr.  sup.,  passes 
through  foram.  supraorbital.,  upwards,  and  divides  into  an  external  and  in- 
ternal branch,  ascending  upon  the  frontal  bone,  for  corrugat.  orbicular,  and 
frontalis  and  skin  of  the  forehead. 

d.  Ciliares  (for.  choroidea,  Corp.  ciliare  and  iris'). 

1.  PosticcB  s.  breves,  arise,  often  from  a  superior  and  inferior  common  trunk, 
pass  along  the  optic  nerve  in  a  tortuous  manner,  surrounding  it  in  clusters, 
perforate  the  sclerotica  with  it,  and  spread  out  in  the  choroidea  and  proc. 
ciliares,  with  ten  to  twenty  branches. 

2.  Media  s.  longce,  an  external  and  an  internal ;  they  perforate  the  sclero- 
tica  rather  farther  from  N.  opticus,  pass  between  sclerotica  and  choroidea 
as  far  as  lig.  ciliare,  where  they  divide,  unite  to  form  circulus  iridis  major, 
out  of  which  also  the  circulus  iridis  minor  arises. 

3.  Anticce  (six  to  twelve  branches  of  the  Artt.  musculares,  or  lacrymalis 
and  supra-orbitalis),  give  some  branches  to  the  fascia,  perforate  the  scle- 
rotica not  far  from  the  cornea,  and  open  into  the  circulus  iridis  major. 
Their  number  is  indefinite. 

e.  Eami  musculares,  a  superior  smaller  (sometimes  wanting),  supplies  mm. 
levatorpalpebr.,  reclus  and  obliquus  superior  ;  an  inferior  passes  between  n. 
opticus,  and  m.  rectus  inferior  supplies  this,  and  rect.  externus  and  obliq.  infe- 
rior; gives  offciliar.  anticce. 

Arising  on  the  inner  side  of  the  Optic  Nerve. 

f.  Ethmoidales,  a  posterior  and  an  anterior  (larger),  pass  under  m.  obliq., 
through  the  foram.  ethmoidalia  out  of  the  orbit  into  the  cranial  cavity,  divide 
(each)  upon  the  superior  surface  of  the  cribriform  plate  into  two  branches  for 
the  dura  mater  and  nasal  cavities.     The  anterior  gives ; 

1.  M.eningea  antica,  for  thefalx  cerebri,  along  the  coronal  suture. 

2.  Nasalis  anterior,  passes  through  an  anterior  foramen  to  the  anterior  part 
of  the  labyrinth  and  the  septum  and  anastomoses  with  branches  of  the 
Spheno-palatina. 

g.  Palpebrales  s.  tarsece,  arise  close  before  the  trochlea.    The  inferior  passes 
behind  lig.  palpebr.  intern,  downwards  and  outwards,  and  passes  close  to  the 
free  border  of  the  lid,  between  the  cartilage  and  muscle  of  the  inferior  eyelid 
as  far  as  the  outer  angle,  forming  an  arch  (arcus  tarsus  infer.)  and  anastomos- 
ing with  the  lacrymalis  and  infraorbitalis,  where  a  branch  for  the  mucous 
membrane  of  the  nasal  canal  then  passes  off.    The  artery  of  the  superior  eye- 
lid descends  to  the  superior  lacrymal  punctum,  then  passes  outwards,  like 
the  inferior  (arcus  tarseus  superior),  and  anastomoses  with  the  lacrymal,  fron- 
talis, temporal,  superfa. 

h.  Nasalis  (s.  dorsalis  nasi),  terminal  branch  of  ophtkalmica,  on  the  internal 
superior  angle  of  the  orbita,  passes  out  of  these  over  lig.  palpebr.  intern  into 
the  face,  and  divides  after  it  has  once  given  off: 


THE  VESSELS.  309 

1.  Art.  tacci  lacrymalis  to  the  mucous  membrane  of  the  lacrymal  sac,  into 

2.  Angularis,  which  passes  between  m.  pyramidalis  nasi  and  levat.  labii 
sup.,  and  anastomoses  with  the  maxillar.  externa.  (See  that  artery.) 

3.  Dorsalis  nasi,  passes  upon  the  back  of  the  nose  under  the  skin  trans- 
versely below  the  forehead,  extends  downwards,  often  to  the  middle  of 
the  nose,  and  anastomoses  on  the  nasal  pinna  with  Art.  alaris  nasi. 

i.  Frontalis,  the  terminal  branch  of  ophthalmica,  smaller  than  h,  passes 
parallel  with  A.  supraorbitalis  upwards  to  the  forehead,  where  it  divides  into 
branches  for  the  skin,  the  muscles,  and  the  periosteum,  and  anastomoses  with 
art.  temporalis. 

552.  2.  Art.  cerebri  anterior  B.  corporis  callosi,  passes  away  above  n. 
opticus,  behind  the  root  of  olfactorius,  (forwards)  and  inwards  towards  the 
middle  line,  and  in  the  fissure  between  the  two  anterior  cerebral  lobes  on  the 
inferior  surface  of  the  brain ;  here,  a  stronger,  short  (two  lines)  transverse 
branch  unites  the  two  anterior  cerebral  arteries,  ram.  communicans  anterior. 
Each  artery  then  turns  round  the  anterior  border  of  corp.  callosum,  passes  upon 
its  superior  surface  to  the  posterior  border,  and  terminates  with  a  small  branch 
curved  upwards  in  the  neighbouring  convolutions.  Branches :  to  nn.  opticus, 
olfactorius,  to  ventriculus  tertius,  to  the  inferior  and  internal  surface  of  the  an- 
terior cerebral  lobes,  to  corp.  callosum. 

3.  Art.  cerebri  media  s.  fossa  Sylvii  passes  externally  and  internally  into 
fossa  Sylvii,  divides  into  three  branches  for  the  anterior  and  middle  cerebral 
lobes,   and  anastomoses  with  Art.  cerebri   anterior  and  posterior.      Small 
branches  pass  directly  from  below  upwards  to  the  corp.  striatum.    Is  larger 
than  2.  and  4. 

4.  Art.  s.  ramus  communicans  (posterior},  arises  from  the  posterior  part  of 
carotis  intern.  ;  passes  under  tractus  n.  optic,  backwards  (one  half  to  three 
quarters  of  an  inch  long),  and  forms  with  art.  cerebri  posterior  (s.  Art.  verte- 
bralis)  the  circulus  arteriosus  Willisii. 

5.  Art.  choroidea  arises  above  the  former,  passes  outwards  and  backwards 
with  the  tractus  n.  opticor.  below  the  crus  cerebri,  enters  into  the  lateral  ven- 
tricle, on  the  cornu  ammonis  around  the  thalamus,  and  ramifies  in  the  vascular 
plexus,  plexus  choroideus  of  the  third  [lateral]  ventricle. 

All  the  arteries  of  the  brain  take  a  very  tortuous  course. 

553.  B.  Subclavia,  the  subclavian  artery. 

Origin :  the  right  from  the  truncus  anonymus ;  the  left  from 
the  arcus  aortce.     (The  right  frequently  arises  below  the  left,  at 
the  posterior  inferior  part  of  the  arcus  aortce,  and  betakes  itself  to 
the  right  behind  trachea  and  oesophagus,  sometimes  between  the 
two).     Course:  ascends  as  high  as  the  apex  of  the  lungs,  curves 
over  the  first  rib,  and  passes  between  scalenus  anticus  and  medius, 
outwards  and  downwards  to  the  axillary  cavity.     The  right  i 
shorter,  thicker,  and  inclines  less  upwards  than  outwards.     Situa 
tion  :  first  portion,  from  the  origin  to  m.  scalenus  anticus. 


310  SPECIAL  ANATOMY. 

The  right  is  covered  before  by  m.  sterno-thyreoid.,  ven.  anonyma, 
n.  vagus  and  phrenicus,  m.  deido-mastoid,  behind,  separated  by 
n.  recurrens  from  m.  longus  colli ;  bounded  internally,  only  a 
little,  by  v.  cephalica,  covered  externally  by  the  pleura;  sur- 
rounded all  round  by  lymphatic  glands,  loose  uniting  tissue,  and 
plexus  of  n.  sympathicus. 

The  left  passes  parallel  with  v.  cephalica,  lies  immediately  upon 
longus  colli ;  and  is  covered  to  a  ^greater  extent  by  the  pleura  ; 
otherwise  like  the  right. 

The  second  portion  lies  close  above  the  centre  of  the  first  rib  in 
the  space  between  the  mm.  scaleni  ;  below  the  two  scaleni  ;  before 
the  plexus  brachialis ;  behind  scalen.  anticus,  before  which  v. 
subclavia  lies. 

The  third  portion  reaches  from  the  outer  border  of  the  scalenus 
antic,  to  the  clavicle,  lies  in  the  triangular^ossa  supraclavicularis  ; 
behind  ven.  subclavia^  m.  subclavius  and  clavicula  ;  before  plexzts 
brachialis  ;  under  m.  platysmam.,  skin  [supra-clavicular,  nerves], 
and  the  obliquely  crossing  art.  et  ven.  suprascapularis  ;  over  the 
first  rib. 

554.  Superior  branches  of  Art.  subclavia. 

1.  Art.  vertebralis,  the  vertebral  artery,  the  largest  branch  of  the  subclavia, 
supplies  the  spinal  cord,  medulla  oblongata,  the  small  and  the  posterior  parts 
of  the  great  brain.  Or:  at  the  superior,  posterior  wall  of  the  subclavia,  at 
the  commencement  from  the  arch.  Course :  vertically  upwards  and  rather 
backwards,  it  enters  between  proc.  transvers.  of  the  sixth  cervical  vertebra 
into  the  canalis  vertebralis,  and  ascends,  slightly  curved,  to  the  second,  turns 
backwards  between  this  and  the  atlas,  more  still  between  atlas  and  foramen 
magnum  behind  proc.  condyloid.  occipit.,  and  enters  the  skull  through  lig. 
obturatorium  and  dura  mater,  round  to  the  front  of  medulla  oblongata,  ascends 
upon  pars  basilaris,  and  unites  with  the  art.  basilaris  of  the  other  side.  Po- 
sition :  at  first  very  deep  between  m.  longus  colli  and  scalenus  antic.,  behind 
art.  thyreoid.  inferior,  then  in  canal,  vertebralis,  in  the  interspaces  covered  by 
mm.  intertransversarii  and  before  the  nn.  cervicales  ;  the  first  curvature  be- 
tween m.  trachelomastoid.  and  obliq.  infr. ;  the  second  between  obliq.  sup. 
rectus  capit.  minor  and  lig.  obluratorium  ;  in  the  cranial  cavity :  at  the  sides 
and  before  medulla  oblongata. 

Branches.     In  the  neck  : 

a.  Rami  spinales  pass  through  the  foram.  intervertebral.  to  the  spinal  cord. 
Several  come  from  art .  cervicalis  and  pharyngea  ascendentes. 

b.  Rami  dorsales  pass  to  the  deep  cervical  muscles  above  the  transverse  pro- 


^  THE  VESSELS.  311 

cess :  anastomosing  with  art.  occipitalis  and  cervical,  profunda  ;  a  larger 
branch. 

Art.  meningea  posterior  enters  through  foram.  magnum  to  the  falx  cere- 
belli. 

In  the  cranial  cavity  : 

c.  Art.  spinalis  posterior,  arises  at  the  sides  of  medull.  oblong,  and  divides 
into  an  ascending  branch  for  the  walls  of  the  fourth  cerebral  ventricle, 
and  a  descending  which  passes  down  on  the  posterior  surface  of  the  spinal 
marrow,  becomes  enlarged  by  the  rami  spinales  passing  into  it,  and  is  thus 
continued  as  far  as  the  inferior  extremity  of  the  vertebral  column.    It 
gives  an  anterior  and  posterior  branch  for  the  posterior  roots  of  the  nn. 
spinales. 

d.  Art.  spinales  anterior,  larger  than  the  former,  arises  close  under  the  art. 
basilaris,  associates  with  that  of  the  other  side,  passes  in  a  groove  on  the 
anterior  surface  of  the  spinal  cord,  as  art.  mediana,  as  far  downwards  as 
the  os  coccyx,  continued  by  branches  of  cervical,  ascendens,  vertebralis,  in- 
tercostales  and  lumbales. 

e.  Art.  cerebelli  inferior  posterior,  arises  on  the  outer  wall  of  vertebral., 
curves  round  before  the  roots  of  the  vagus  and  hypoglossus,  backwards 
round  the  medulla  oblong.,  passes  forwards  between  the  central  and  lateral 
lobes  of  the  cerebellum,  and  divides  into  an  internal  and  external  branch, 
the  last  of  which  ramifies  on  the  inferior  surface  of  the  cerebellum,  and 
anastomoses  with  art.  cerebelli. 

555-  Art.  s.  truncus  basilaris,  the  continuation  of  the  two  Artt. 
vertebrates,  commences  in  the  sulcus  between  medull.  oblong,  and 
Pons  Varolii,  and  terminates  on  the  anterior  border  of  the  last. 
Its  inferior  wall  rests  upon  the  clivus ;  its  superior  wall  gives  nu- 
merous branches  to  the  Pons  Varolii ;  from  the  lateral  walls 
arise  : 

f.  Art.  cerebelli  inferior  anterior  arises  in  the  middle  of  art.  basilar.,  passes 
outwards  under  nerv.facialis  and  acusticus  to  lobul.  anterior  cerebelli. 

1.  Auditiva  interna  passes  off  from  it,  or  the  basilaris  itself,  and  goes 
with  nerv.  acusticus  to  the  cochlea  and  vestibule. 

g.  Art.  cerebelli  superior  arises  close  to  the  anterior  extremity  of  art.  basila- 
rig,  behind  n.  oculo-motorius,  turns  round  pedunculus  cerebri  upon  the 
superior  surface  of  Pons  Varolii,  and  supplies,  divided  into  an  external 
and  an  internal  branch,  the  borders  and  superior  surface  of  the  cerebellum. 

h.  Artt.  cerebri  posterior es  s.  prof  unties,  the  two  terminal  branches  of  basilaris, 
pass  forwards,  diverging,  bend  backwards  upon  the  superior  [inferior] 
surface  of  pedunculi  cerebri  to  the  inferior  of  the  posterior  lobes  of  the 
brain  ;  give,  quite  at  the  commencement,  numerous  branches  to  the  sub- 
slant,  perforata  grisea  between  the  crura  of  the  brain  ;  receive  ramus  com- 
municans,  which  passes  off  from  Carotis  interna,  and  thus  completes 
the 


. 

312  SPECIAL  ANATOMY. 

heptangular  circulus  arteriosus  Willisii,  which  lies  over  the  sella  tur- 
cica,  and  surrounds  the  hypophysis  cerebri.  It  is  formed  :  the  anterior 
transverse  wall  by  ramus  communkans  anter.,  the  anterior,  central,  and 
posterior  lateral  walls  by  Artt.  cerebri  anter.,  communicant,  posterr., 
cerebri  profundae. 

556.  2.  Art.  thyreoidece  inferior,  in  the  child  larger,  is  sometimes  want- 
ing.    Origin:  close  and  next  to  art.  vertebr.,  rather  external  (frequently  in 
common  with  supra- scapularis,  as  thy  reo- cervicalis).     Course  :  first  upwards 
to  the  lateral  border  of  the  thyroid  cartilage.     Position  :  before  the  first  curve, 
carotis  communis,  ven.  jugular,  intern.,  n.  Vagus,  and  sympathicus  (ganglion 
cervicale  med.)  ;    before  the  second  curve,  nerv.  recurrens  ;  behind  it,  art. 
vertebral,  andlongus  colli  ;  oesophagus  (to  the  left).     Branches  :  to  esophagus, 
trachea,  m.  scalenus  antic.,  and  longus  colli.     Farther : 

a.  Cervicalis  ascendens  :  ascends  before  scalen.  antic.,  then  between  it  and 
rectus  capit.  antic,  directly  upwards  to  the  basis  cranii,  gives  rami  mus- 
culares,  and  especially  rr.  spinales,  which  anastomose  with  the  vertebralis. 
With  it  is  generally  united  : 

art.  cervicalis  superjicialis  (into  a  common  trunk ;  thyreo-cervicalis). 
Course  :  transversely  outwards  through  the  fovea  supraclavicul.,  to  the 
border  of  cucullar.  Position:  before  scalen.  antic. ,plex.  brachial.,  levator 
scapul.,  and  omo-hyoideus ,  one  inch  above  the  clavicle,  higher  than  the 
suprascapularis  ;  supplies  cucull.  scap.,  splenii,  levator,  &c. 

b.  Laryngea  inferior  (s.  thyreoidea  superior,  see  before). 

c.  Terminal  branches,  three;  1,  at  the  inferior  border;  2,  at  the  sides  of 
the  posterior  surface  of  the  thyroid  gland  ;  3,  at  the  inferior  border  of 
cartil.  cricoidea. 

Art.  thyreoidea  infima  (Neubauer)  is  not  always  present :  arises  from  arcus 
aortce,  carotis  communis,  or  thyreoid.  inferior  ;  passes  before  the  trachea  to 
the  gland. 

557.  Superior  external  branches  of  the  Subclavia. 

3.  Scapularis  posterior  (s.  transversa  cervicis).     Origin  :  generally  outside 
Scaleni  (or  inside,  in  common  with  thyreoidea  infer.  ;  or  between  them,  in 
common  with  the  suprascapular.).     Course  :  transversely  outwards  through 
plexus  brachialis,  curving  backwards  towards  the  superior  posterior  angle  of 
the  scapula  ;  divides  into  : 

a.  Cervicalis  suprema  ;  ascends  under  the  cucullar.,  ramifying  in  it,  levator 
scap.,  and  splenius. 

b.  Dorsalis  scapula  winds  under  the  levator  and  the  angle  of  the  scapula, 
descends  along  the  spinal  border  to  the  inferior  angle  between  rhomboid. 
and  serratus  post.,  and  anastomoses  with  suprascap.  and  scapul.  inferior. 

Situation  :  at  first  horizontally  in  the  fossa  supraclavicular.,  covered  by 
platysmamyoid.,  omohyoid.,  later  by  cucullaris  and  levator  scapulae. 

4.  Suprascapularis  s.  transversa  scapulae.  Or. :  below  art.  thyreoid .  inferior 


THE  VESSELS.  313 

(in  common  with  it  and  cervical,  superjlc.,  when  the  last  arises  internal  to 
mm.  scaleni).  Course  :  obliquely  outwards  and  downwards  under  cervical. 
superficial.,  behind  the  clavicle,  above  the  superior  border  of  the  scapula 
(over  lig.  incisurce  semilunaris)  to  the  fossa  supra-  and  infra- spinata.  Situa- 
tion: at  first  covered  by  sterno-cleidom.,  then  by  subclavius,  before  scalen. 
anticus,  art.  subclavia,  and  plex.  brachialis,  above  vtn.  subclavia,  afterwards 
under  trapezius  ;  on  the  scapula  between  the  bone  and  supraspinatus. 
Branches  to  subclavius,  trapezius,  supra-  and  infra- spinatus,  and  periosteum 
of  acromion. 

5.  Cervicalis  profunda.     Or. :  the  furthest  outwards,  in  common  with  art. 
intercostal,  prima.     Course  :  upwards  and  backwards,  then  outwards  between 
proc.  transvers.  of  the  seventh  vertebra  and  the  first  rib,  upwards  upon  multi- 
fidus  and  semispin.  cervicis  as  far  as  the  atlas  ;  a  branch  descends  to  the  mid- 
dle of  the  back  between  longissimi  dorsi.     Situation :  behind  scaleni,  then 
deeper.     Branches :  to  the  deep  layers  of  cervical  muscles. 

558.  Inferior  branches  of  the  Subclavia. 

6.  Intercostalis  prima,  supplies  the  first  and  second  (and  third)  intercostal 
space.     Or. :  behind,  under  A.  cervical,  profunda.     Course  :  passes  before  the 
neck  of  the  first  rib,  curving  backwards  and  downwards  on  the  outside  of 
gangl.  dorsale,  to  the  inferior  border  of  the  first  (and  second)  ribs.    Branches  : 

a.  Samus  dorsalis  ;  passes  backwards,  sends  a  ramus  spinal,  through 
foram.  intervertebr. 

b.  Bam.  intercostalis  passes  forwards  between  mm.  intercostales. 

7.  Mammaria  (s.  thoracica)  interna,  the  internal  mammary  artery.     Or. :  in 
front  under  Art.  thyreoid.  inferior.     Course  :  vertically  downwards  behind  the 
sternal  extremity  of  the  clavicula  and  the  cartilages  of  the  first  to  the  sixth 
ribs,  where  it  divides  into  an  external  and  an  internal  branch.     Situation  :  at 
first  behind  m.  scalenus  antic,  and  n.phrenicus,  then  upon  the  inner  side  of  the 
last,  a  line  and  a  half  to  two  lines  from  the  border  of  the  sternum,  before  m. 
triangular,  sterni  and  pleura. 

Branches.     1 .  Posterior,  in  the  chest. 

a.  Artt.  thymicce,  in  children  very  large,  to  the  Thymus. 

b.  Art.  pkrenica  superior,  with  N.  phrenicus,  passes  between  pericardium 
and  anterior  mediastinum  to  the  diaphragm.   Branches  to  the  pericardium, 
Thymus. 

2.  External  branches  of  the  mammaria  interna. 

c.  Artt.  intercostales  anteriores  ;  the  two  pass  to  the  superior  and  inferior 
borders  of  the  first  and  second  intercostal  spaces ;  supply  mm.  Intercast, 
and  pleura,  anastomosing  with  artt.  intercostales  posterr.  (see  Aorta). 

3.  Anterior  branches  of  mammaria  interna. 

d.  Artt.  mammarice  externce  (six  to  seven)  pass  directly  from  behind  for- 


314  SPECIAL  ANATOMY. 

wards,  perforate  the  mm.  intercostales,  and  divide  into  muscular  and  cuta- 
neous branches  (for  mm.  pectoralis  and  intercostales) ;  the  superior  pass  to 
the  thoracic  glands,  and  are  very  greatly  developed  in  mammalia.  Some 
branches  (r.  sternales)  go  into  the  periosteum  of  the  sternum  ;  others  per- 
forate the  last. 

559.  The  terminal  branches  of  the  mammaria  internet,. 

e.  Musculo-phrenica  passes  obliquely  outwards  and  downwards,  behind  the 
seventh  to  the  eleventh  rib  cartilage,  before  the  diaphragm  ;  terminates  in  the 
twelfth  intercostal  space,  and  gives  besides,  for  the  seventh  to  tenth,  the  artt- 
intercostales  anterr.    Anteriorly  :  branches  for  the  diaphragm  and  mm.  obliqui 
abdominis. 

f.  Epigastrica  superior,  smaller,  passes  out  behind  the  seventh  rib  cartilage 
from  the  chest ;  passes  behind  and  in  the  sheath  of  m.  rectus  as  low  as  the 
umbilicus,  there  ramifies,  and  anastomoses  with  the  capillary  rete  of  art. 
epigastrica  (inferior) ;  a  branch  passes  in  the  form  of  an  arch  upon  the  ante- 
rior surface  of  process,  xiphoideus. 

560.  Axillaris,  the  Axillary  artery, 

a  continuation  of  the  a.  subclavia,  reaches  from  the  clavicle  as  far 
as  the  inferior  border  of  the  m.  pectoralis  major,  passing  in  the 
oblique  diameter  of  the  axillary  cavity. 

Situation :  surrounded  by  lymphatic  glands  and  loose  uniting 
tissue  behind  :  m.  subclavius,  pectoralis  major  and  minor,  lastly, 
m.  coracO'brachialis ;  before :  the  uniting  tissue  between  m.  sub- 
scapular,  and  serratus  posticus  major  ;  farther  down  before  m. 
tcres  major  and  latissimiis  dorsi.  Internally,  it  rests,  at  first,  upon 
the  first  rib  and  first  intercostal  space,  then  at  a  distance  from  the 
thorax,  and  is  only  covered  by  fascia  and  skin ;  on  the  outer  side 
is  situated  :  caput  humeri  (m.  subscapular.). 

Close  under  the  clavicle  we  find  ven.  axillaris  ;  internally,  vv. 
cephalica  and  acromialis  before  art.  axillaris  ;  plexus  brachialis 
externally,  one  n.  thoracicus  before  it,  farther  down  n.  medianus 
and  cubitalis  before,  n.  radialis  behind  it.  We  find  the  axillaris 
at  the  superior  external  border  of  the  growth  of  hair  in  the  axillary 
cavity.  Branches :  three  thoracici,  one  subscapular,  two  circum- 
flexa. 

561.  Above  the  pectoralis  minor : 

a.  Thoracica  1.  s.  suprema  arises  from  the  inner  side  of  a.  axillaris;  passes 
over  the  superior  border  of  m.  pectoral  minor  downwards  and  inwards 
between  mm.  pectoral,  major  and  minor,  and  ramifies  in  them.  Anasto- 
moses with  the  sup.  intercost. 


THE  VESSELS.  315 

b.  Thoracica  11.  8.  acromialis  arises  generally  in  common  with  a  and  divides 
into : 

1.  Ram.  deltoideus,  which  passes  close  to  Ven.  cephalica  downwards  in 
a  groove  of  uniting  tissue  between  m.  pectoralis  and  deltoid,  and  ter- 
minates in  the  last. 

2.  Ram.  acromialis  passes  away,  covered  by  m.  deltoideus,  transversely 
outwards,  above  proc.  coracoid.,  lig.  coraco-acromiale,  and  the  exter- 
nal extremity  of  the  anterior  border  of  the  clavicula  to  the  shoulder- 
joint  ;  anastomoses  with  transfers,  scapulae. 

t 

562.  Below  the  pectoralis  minor  : 

c.  Thoracica  111.,  B.  longa,  s.  inferior,  s.  mammaria  externa,  passes  down- 
wards and  forwards  on  the  side  of  the  thorax  between  m.  pectoral,  major 
and  serratus  magnus,  then  between  this  and  the  skin,  terminating  on 
the  sixth  intercostal  space  ;  it  gives  branches  to  the  axillary  and  mam- 
mary glands,  the  muscles  of  the  second  to  the  sixth  intercostal  spaces. 

563.  Branches  of  the  axittaris  at  the  coUum  humeri. 

d.  Subscapularis.    The  largest  branch  of  axillaris  arises  from  the  outer 
side  of  it  between  N.  radialis  (within)  and    IV.  medianus  (without). 
Course  :  curved  outwards  and  downwards,  parallel  with  m.  teres  major, 
on  the  anterior  (external)  border  of  the  scapula.    Position :    before  m. 
fcapularis.     Branches  :    to  m.  scapularis,  teres  major,  and  two  terminal 
branches. 

1.  Art.  tkoracico-dorsalis  passes  downwards  along  the  anterior  border 
of  the  Scapula,  behind  Art.  thoracica  longa,  between  latissim.  dorsi 
and  serratus  anticus,  and  ramifies  in  them. 

2.  Art.  circumflexa  scapulce,  before  the  long  head  of  m.  triceps,  turns 
round  the  attachment  of  this  to  the  anterior  border  of  the  Scapula 
backwards  to  the  fossa  infraspinata,  covered  by  m.  infraspin.,  sends 
an  anterior  branch  between  fossa  and  m.  sub  scapular  is,  and  anasto- 
moses with  art.   transversa  scapul.   (above)    and    thoracico-dorsalis 
(below). 

e.  Circumflexa  humeri  anterior,  small,  arises  on  the  anterior  outer  side  of 
axillaris,  often  in  common  with  the  following.     Course :   transversely 
outwards  above  the  tendons  of  latissim.  dorsi  and  teres  major,  around  the 
anterior  surface  of  collum  humeri  backwards.     Situation  :  behind  coraco- 
brachial.  and  biceps.    Branches  to  collum  humeri  [and  head,  gives  off  the 
epiphysial  artery.] 

f.  Circumflexa  humeri  posterior;  larger.     Origin :  at  the  posterior  outer  side 
of  axillaris,  opposite  to  sub  scapularis.     Course  :  transversely  backwards 
and  outwards  round  the  posterior  surface  of  collum  humeri  to  the  outside 
of  it ;  terminates  in  m.  deltoideus.    Situation  :  close  to  Ven.  circumfl.  and 
Art.  axillaris,  before  cap.  long.  m.  tricipitis,  latissim.  dorsi,  above  teres 


316  SPECIAL  ANATOMY. 

major,  below  teres  minor,  behind  os  humeri.    Branches  to  the  articular 
capsule,  periosteum,  and  m.  deltoideus. 

564.  Brachialis,  the  Brachial  artery. 
Continuation  of  axittaris,  reaches  as  far  as  the  fore-arm,  where 

it  bifurcates.  Course:  extends  downwards  first  on  the  internal, 
then  on  the  anterior  surface  of  the  upper  arm,  so  that  it  is  situated 
in  front  of  the  elbow-joint  in  the  centre  of  the  flexure.  Situation  : 

565.  1.  In  the  upper  arm :  * 

covered  in  front  and  above  by  m.  coraco-brachialis,  then  by  the 
internal  border  of  m.  biceps;  behind  and  above  by  m.  triceps,  then 
by  brachialis  internm  ;  internally  by  fascia  brachialis  and  skin  ; 
externally  accompanied  by  m.  coraco-brachialis  and  the  internal 
surface  of  the  Humerus  ;  in  a  common  sheath  with  n.  medianus. 
Vv.  brachiales  lie  on  both  sides;  N.  medianus  above  on  the  out- 
side, in  the  middle  in  front,  below  on  the  inner  side ;  N.  cubitalis 
above  on  the  inner  side ;  N.  radialis  behind  the  brachial  artery. 

566.  2.  In  the  flexure  of  the  arm  : 

separated  before  byv.mediana,  aponeurosis  bicipitis  from  the  skin ; 
behind  by  m.  brachialis  internus  from  the  joint ;  on  the  inside  of 
the  tendon  of  m.  biceps  ;  on  the  outside  of  the  n.  medianus  and 
in.  pronator  teres. 

Branches  sixteen  to  twenty ;  external  anterior  for  mm.  coraco- 
brachial.,  biceps,  brachial.  intern.^  and  deltoid ;  internal  posterior 
for  m.  brachial.  internus. 

Nutritia  humeri  arises  from  a  muscular  branch,  or  from  profunda  brachii, 
enters  into  the  foramen  above  the  centre  on  the  inner  side  of  the  humerus. 
Also  the  following: 

1.  Profunda  brachii.     Or.:  often  in  common  with  circumfl.  poster.,  on  the 
inferior  border  of  teres  major.     Course  :  downwards  and  backwards,  close  to 
N.  radial.,  round  the  posterior  circumference  of  os  humeri,  in  a  groove  which 
it  abandons  under  the  attachment  of  m.  deltoid.,  and  divides  into  a  deep  and 
superficial  branch.    Situation :  between  os  humeri  and  m.  triceps,  then  between 
triceps  and  brachial  intern.     Branches : 

a.  Collateralis  radialis  profunda,  accompanying  the   n.  radialis,  between 
cap.  intern,  and  extern,  tricipitis  ;  supplies  these  ;  anastomoses  with  2. 

b.  Collateralis  radialis  superficialis  passes  directly  downwards  along  the  lig. 
intermuscl.  extern,  behind  the  condyl.  extern,  and  anastomoses  with  a.  re- 
currens  radialis. 

2.  Collateralis  ulnaris  superior  (prima),  [s.  profunda  inferior]  arises  close 
next  to  or  from  the  profunda  brachii,  passes  downwards  on  the  inner  side  of 


THE  VESSELS.  317 

triceps,  perforates  the  lig.  intermusc.  intern,  (with  n.  cubital.),  and  reaches  as 
tar  as  the  articulation,  where  it  supplies  the  triceps  and  brachial.  intern. 

3.  Collateralis  ulnaris  inferior  [a.  anastomodicd] ,  arises  above  the  elbow, 
passes  obliquely  downwards  and  inwards,  towards  condyl.  hum.  intern.,  and  is 
lost  in  rete  articulare  cubiti,  m.  brachialis  and  pronator  teres. 

The  brachial  artery  bifurcates  commonly  (half  an  inch)  below, 
sometimes  in,  frequently  also  above  the  flexure  of  the  arm  into  art. 
radialis  and  ulnaris  (at  the  inferior  or  superior  third  of  the  upper 
arm,  indeed,  even  in  the  axillary  cavity.  Cruveilhier.) 

567.  I.  Radialis,  the  radial  artery, 

the  external,  smaller,  and  more  superficial  branch  of  art.  brachialis, 
passes  directly  downwards,  and  rather  obliquely  outwards,  along 
the  internal  border  of  the  radius,  as  far  as  the  articulation  of  the 
hand,  turns  round  the  proc.  stijloid  radii  and  os  naviculare  upon 
the  dorsal  surface  of  the  carpus,  and  immediately  again  between 
the  first  and  second  metacarpal  bones  forwards  into  the  hollow  of 
the  hand,  and  forms  the  arcus  volaris  profundus.  Situation : 

a.  From  the  commencement  to  the  carpus  :  behind  the  internal 
border  of  m.  supinator  longus,  below  covered  only  by  the  fascia 
and  skin ;  upon  m.  supinator  brevis,  pronator  teres,  flex,  digit, 
sublim.,  long,  pollic.,  pronat.  quadrat.,  then  close  upon  the  bone 
on  the  inner  side  of  the  tendon  of  m.  supinator  longus  and  the  n. 
radialis. 

b.  On  the  carpus:  covered  obliquely  by  the  tendons  of  abductor 
pollic.  long.,  flex,  long.,  and  brevis,  close  upon  the  bones. 

c.  In  the  hollow  of  the  hand  (see  arcus  volaris  profundus.) 
Variety.     It  frequently  inclines  to  the  back  of  the  fore-arm  at  a 

point  higher  up  (two  or  three  inches  above  the  carpus.) 

Besides  many  (forty)  muscular  branches  and  a  transversa  carpi 
volaris  to  the  rete  carpeum  volare,  the  radial  artery  yet  gives  off  the 
following  branches  : 

1.  Recurrens  radialis. — Origin: — behind,  close  to  the  commencement  of 
art.  radialis  (also  from  the  brachialis).     Course :  runs  outwards  and  up- 
wards to  condylus  externus.    Situation :  between  supinat.  long,  and  brevis 
(above  brachialis  intern.).  Anastomoses  with profunda  humeri.  Branches: 
from  the  convexity  downwards  and  outwards  to  mm.  supinatores  and  ra- 
diales  extern.;  to  the  rete  articulare  cubiti. 

2.  Eamus  volaris  superficial^,  s.  radio-palmaris.     Or. :  above  os  naviculare 
from  the  inner  side  of  art.  radialis.     Course  :  passes  over  the  origin  of  oi- 
ductor  pollic.  brevis,  on  the  external  border  under  aponeurosis  palmaris  to 
the  arcus  volar.  sublimis.    Branches  to  the  muscles  of  the  thumb,  or  even 
to  the  outer  side  of  the  middle  and  the  two  sides  of  the  index  fingers. 


318  SPECIAL  ANATOMY. 

3.  JRamus  dorsalis,  the  termination  of  art.  radialis  upon  the  back  of  the 
carpus  (see  above),  gives  off: 

a.  Transversa  carpi  dorsalis,    passes  transversely  over  the  middle  of 
the  back  of  the  carpus,  inwards,  to  the  rete  carpeum  dorsale;  anas- 
tomoses with  a.  ulnaris,  and  gives  off  ascending  and  descending 
branches. 

b.  Interossea  IL  s.  metacarpi  dorsalis,  passes  between  the  second  and 
third  metacarpal  bones,  passes  at  the  inferior  extremity  forwards  to 
the  arc.  volaris  sublimis,  where  two  branches  are  then  given  off: 

1.  Art.  dorsalis  radialis  digiti  medii,  for  the  external  border  of  the 
middle  finger. 

2.  Art.  dors,  ulnaris  indicis,  for  the  internal  border  of  the  thunr  b. 

c.  Interossea  1.,  passes  between  the  first  and  second  metacarpal  bone, 
and  gives  off: 

1.  Art.  dors.  rad.  indicis  for  the  radial  border  of  index  finger. 

2.  Art.  dors,  ulnaris  pollicis,  for  the  ulnar  border  of  thumb. 

d.  Princeps  s.  magna  pollicis ,  passes  between  the  muscles  of  the  ball  of 
the  thumb  and  the  volar  side  of  the  first  metacarpal  bone  to  the  first 
phalanx  on  the  radial  side. 

Rete  articulare  cubiti,  the  anastomosis  about  the  elbow-joint,  is 
formed : 

1.  Above  by  collateralis  radialis,  ulnaris  superior  and  inferior. 

2.  Below  by  recurrens  radialis,  ulnaris,  and  interossea  (which 
see.) 

568.         II.    Ulnaris  s.  cubitalis,  the  ulnar  artery, 

the  internal,  larger  branch  of  brachialis,  at  first  slightly  curved 
upwards  and  backwards,  it  passes  backwards  and  inwards,  then 
(three  lines  from  the  origin)  extends  downwards  on  the  anterior 
surface  of  the  Ulna  as  far  as  the  carpal  articulation  ;  hence,  on 
the  outer  (radial)  side  of  os  pisiforme,  above  the  lig.  carpi  volare 
propr.  to  the  hollow  of  the  hand  in  the  arcus  volaris  sublimis. 
Position :  at  first  deep  behind  mm.  pronat.  teres,flex.  carp,  radial, 
palmar,,  flex.  dig.  sublimis,  and  N.  medianus,  then  superficially, 
between  the  tendons  of  flex,  sublim.  (outside)  and  carpi  ulnaris 
(inside)  ;  upon  m.  brachial.  intern.,  flex,  profund.,  and  pronator 
quod.,  the  ulna  ;  on  the  outer  side  of  Nerv.  ulnaris  ;  at  first  out- 
side, then  behind,  at  last  inside  JV.  medianus.  Branches  to  the 
muscles  ;  also  : 

1.  Recurrens  ulnaris.— -Origin :  from  the  posterior  wall,  one  inch  from  the 
origin  of  the  ulnaris.  Course  :  deeply  under  the  muscles  towards  the  inside, 
between  condyl.  internus  and  olecranon,  upwards  to  the  rete  articulare  cubiti. 


THE  VESSELS.  319 

Position :  covered  by  pronator  teres,  flex,  sublim.,  palmar  long.,  flex.  carp, 
ulnar.,  passing  before  N.  ulnaris.  Branches :  a.  an  anterior  between  pronator 
teres  and  brachialis  interims  ;  b.  to  N.  ulnaris  above. 

2.  Interossea. — Origin  :    from  the   ulnaris  behind,  close  under   the  last. 
Course  :  directly  backwards  and  downwards,  to  the  centre  of  the  fore-arm ; 
it  bifurcates  into  : 

a.  Interossea  anterior  (s.  interna). — Origin :  above  lig.  interosseum.   Course  : 
on  the  anterior  surface  of  lig.  interosseum,  between  flex,  digit,  profund.  (in- 
side), pollic.  Z<mgtts"(outside),  perforates  under  pron.  quadrat,  the  lig.  in- 
teross.,  and  passes  upon  the  dorsal  surface  of  the  carpus  into  the  rete  dor- 
sale.     Branches :  several  artt.  perforantes  pass  through  lig.  inteross.  back- 
wards to  the  deep  muscles ;  an  anterior  superior  branch  accompanies  the 
nerv.  medianus  as  far  as  the  hand ;  an  inferior  passes  behind  pronat  qua- 
dratus  downwards  to  the  rete  carpi  volare. 

b.  Interossea  posterior  (s.  externd) ;  smaller  than  the  last ;  passes  through 
two  inches  below  the  articulation  between  ulna  and  radius  upon  the 
dorsal  region  of  the  fore-arm,  and  divides  immediately  into: 

1.  Interossea  recurrens  (s.  radial,  poster.) ;  ascends  on  the  radial  side 
of  the  ulna,  covered  by  anconeus  parvus,  to  the  rete  cubitale. 

2.  Interossea  descendens,  descends,  nearer  to  the  ulna,  upon  the  dorsal 
side  of  lig.  inteross.  as  far  as  the  carpus.     Branches  to  extens.  com- 
mun.  digit.  5,  carp,  ulnaris  and  skin. 

3.  Art.  nutritia  ulnaris,  a  small  branch,  about  the  middle  of  the  art.  ulnaris, 
passes  through  a/oram.  nutritium  in  the  ulna  [from  below  upwards] ;  some- 
times also  a  branch  to  the  radius  (or  even  from  the  anterior  circumference  of 
interossea  anterior). 

4.  Eamus  dorsalis,  terminal  branch  of  ulnaris,  passes  under  the  tendon  of 
m.  flex .  carpi  ulnaris  to  the  back  of  the  carpus  into  the  rete  carpi  dor  sale  ; 
giving  off  in  its  passage  the  dorsal,  ulnar.  to  the  little  finger. 

5.  Ramus  volaris,  terminal  branch  of  the  ulnaris,  passes  close  to  os  pisi- 
forme,  and  above  os  hamatum  (hamulus)  and  lig.  carp,  propr.,   covered  by 
aponeurosis  palmar,  and  m.  palmar,  brevis,  into  the  hollow  of  the  hand,  gives 
branches  to  the  muscles  of  the  ball  of  the  little  finger,  and 

a.  Sam.  subtimis,  which  externally  passes  into  arc.  volaris  sublimis  ;  and, 

b.  Earn,  profundus,  which  gives  off  an  internal  branch  for  the  volar  surface 
of  the  little  finger,  and  under  the  tendons  of  mm.  flexor,  digit,  goes  to  form 
arc.  volar.  profund. 

569.  The  vascular  arches  of  the  hand. 

1.  Arcus  (s.  rete)  carpi  dorsalis,  is  situated  upon  the  dorsal  surface  of  the 
metatarsus,  covered  by  lig.  carpi  dorsale,  and  the  tendons  of  the  extensor 
muscles  ;  is  formed  by  ram.  transvers.  of  art.  radialis  and  ulnaris  ;  gives  off: 

a,  Eamiascendentes,  which  pass  opposite  to  branches  of  art.  inteross.  anter. 

b.  Eami  descendentes,  the  short  roots,  anastomosing  with  artt.  perforantt. 
arcus  volaris  profundi  of 


320  SPECIAL  ANATOMY. 

Artt.  interossece  metacarpi  dorsales.  These  are  larger  or  smaller,  going 
along  to  the  inferior  extremity  of  spaces  between  the  metacarp. 
bones,  or  to  the  articulations  of  the  first  and  second  phalanx,  pass 
with  branches  of  arcus  volar.  sublimis,  and  assist  in  forming  art.  digi- 
tales. 

2.  Arcus  volaris  prof undus,  lies  close  upon  the  palmar  surface  of  the  basis 
ossium  metacarpi,  covered  by  the  nerves,  tendons,  and  muscles  of  the  palm  of 
the  hand,  below  slightly  convex;  principally  formed  of  the  transversely  pass- 
ing terminations  of  art.  radialis  ;  gives  off: 

a.  Kami  ascendentes,  very  short  branches  for  the  carpus,  which  anastomos- 
ing with  branches  of  radialis  and  ulnaris  (and  interossea}  form  the  rete 
carpeum  volar e. 

b.  Eami  descendentes  s.  interossece  volares,  three  to  four;  they  pass  in  the 
second  to  the  fourth  spatium  inteross.  metacarpi,  at  the  inferior  extremi- 
ties of  which  they  anastomose  with  the  branches  of  arcus  volare  sublimis. 
The  first  and  largest  at  the  radial  border  of  the  index  finger  is  often 
wanting. 

c.  Kami  perforantes,  three,  pass  at  the  superior  extremities  of  the  second  to 
the  fourth  spat,  inteross.  metacarpi,  from  before  backwards  to  the  rr.  de- 
scendent.  art.  radialis,  and  form  with  these  the  small  interossece  dorsales. 
(See  arcus  dorsalis.) 

3.  Arcus  volaris  sublimis,  lies  in  the  palm  of  the  hand,  covered  by  aponeu- 
rosis  palmaris,  upon  the  tendons  oi  flexor  r.  digitor.,  below  convex;  rather 
nearer  to  the  carpal  articulation  than  the  deep  arch ;  chiefly  formed  of  ram. 
sublimis  art.  ulnaris.    From  the  convexity  arise : 

Art.  digitales,  three,  which  pass  between  the  tendons  of  the  flexors  of 
the  fingers  to  the  heads  of  the  ossa  metacarpi,  in  the  second  to  the  fourth 
interspaces,  there  anastomosing  with  the  interossece  dorsales  ;  they  bifur- 
cate, and  thus  supply  the  radial  border  of  the  five  fingers,  and  the  ulnar 
border  as  far  as  the  second  finger.  On  the  anterior  surface  of  the  pha- 
langes, lying  close  to  the  flexor  tendons,  they  send  branches  to  the  dorsal 
surface,  which,  like  these,  but  smaller,  pass  to  anastomose  with  each 
other  by  means  of  transverse  branches,  and  give  branches  to  the  skin. 
The  radial  border  of  the  index  finger  and  thumb  is  supplied  by  ram.  volaris 
art.  radialis,  which  anastomoses  with  the  arcus  volaris  sublimis. 

Aorta  descendenst  the  descending  aorta. 

570.     A.  Aorta  descendens  thoracica,  the  thoracic  aorta. 

Position :  on  the  left  side  of  the  twelfth  [eighth  inferior]  dorsal 
vertebra,  seven  to  eight  inches  long,  before  the  vertebral  column 
(above  separated  by  duct,  thoracic.) ;  behind  the  left  pulmonary 
vessels  (above),  the  oesophagus  (below),  and  the  pericardium  (in 
the  centre) ;  has  to  the  left  the  mediastinum,  to  the  right  the  oeso- 


THE  VESSELS.  321 

phagus  (above),  Ven.  azygos  and  duct,  thoracicus  close  to  it  (above, 
where  it  winds  to  the  left,  behind  it) ;  is  surrounded  by  much  adi- 
pose tissue,  and  many  lymphatic  glands.  Branches  : 

1.  Artt.  bronchioles,  two  to  the  left,  one  to  the  right ;  they  arise  sometimes 
from  a  common  trunk,  from  the  anterior  wall  of  the  aorta  (also  from  mam- 
mar,  interna  or  subdavia),  and  pass  forwards  to   the   posterior  wall  of  the 
bronchus,   ramifying  on  the   bronchia  and  pulmonary  vesicles;    they  give 
branches  to  the  oesophagus;  bronchial  glands,  and  anastomose  with  the  coro- 
nary arteries  of  the  heart  and  thyreoidea  inferior. 

2.  (Esophagea,  five  to  seven,  thin  and  long,  arising  in  front  from  the  aorta; 
they  pass  to  the  anterior  surface  of  the  oesophagus,  in  the  mucous  membrane 
of  which  they  terminate,  and  send  long  branches  upwards  and  downwards. 

3.  Mediastinaposticce,  small  branches  for  the  posterior  wall  of  the  pericar- 
dium and  the  mediastina.     Two  phrenicce  superiores  arise  deeply,  pass  to  the 
internal  crura  of  the  diaphragm,  and  anastomose  with  the  cesophageee. 

4.  Jntercostales  posteriores,  eight  to  nine  for  the  second,  or  third  to  eleventh 
intercostal  space  (the  first  and  second  are  supplied  by  intercostal,  prima.    See 
subdavia).     Origin :  from  the  lateral  walls  of  the  aorta ;  the  superior  at  an 
acute,  the  inferior  at  a  right  angle.     Course  :  the  superior  upwards,  the  infe- 
rior more  horizontally  outwards,  over  the  heads  of  the  ribs  into  the  intercostal 
space  next  above,  and  divided  between  the  heads  of  the  two  ribs  into  ram.  an- 
terior and  posterior.     Situation :  behind  the  pleura  and  the  trunk  of  sympathi- 
cus;  the  right  behind  the  oesophagus,  ductus  thoracicus;  and  Ven.  azygos  also  ; 
the  left  behind  v.  hemiazygos  and  sympathicus;  the  two  last  (right  and  left)  co- 
vered by  the  crura  of  the  diaphragm. 

Branches :  besides  many  small  osseous  branches  for  the  bodies  of  the  ver- 
tebrae, the  following: 

a.  Ramus  anterior  s.  intercostal  is,  passes  in  the  direction  of  the  trunk,  in  the 
centre  of  the  intercostal  spaces,  at  first  between  pleura  and  m.  intercost. 
intern.,  then  between  intern,  and  extern.,  and  there  divides  into : 

1.  Ram.  sup.  8.  infracostalis,  the  continuation  of  the  trunk  which  passes 
on  the  inferior  border  of  the  rib  situated  above,  in  a  proper  groove, 
as  far  as  the  anterior  third,  then  in  the  middle  of  the  intercostal  space, 
descending  and  anastomosing  with  a.  mammar.  intern.,  epigastrica, 
phrenica,  circumfiexa  tiei. 

2.  Ram.  inferior,  supracostalis,  which  passes  to  the  superior  border  of 
the  rib  lying  below,  and  is  lost  in  the  periosteum  and  the  muscles. 

b.  Ramus  posterior  s.  dorsalis;  passes  between  process,  transversi,  on  the 
external  border  of  lig.  colli  costa  intern,  backwards,  and  divides  into  : 

1.  Ram.  spinalis,  which  passes  through  foram.  intervertebrale,  with  a 
branch  for  the  body  of  the  vertebra,  with  another  for  the  medulla  spin. 

2.  Ram.  muscularis,  a  larger  branch,  which  ramifies  between  longissim. 
dorsi  and  ileocostalis,  and  is  lost  in  the  skin. 

21 


322  SPECIAL  ANATOMY. 

571.  B.  Aorta  descendens  abdominalis,  the  abdominal  aorta. 

Situation :  almost  in  the  middle,  yet  rather  to  the  left,  before  the 
first  to  the  fourth  abdominal  [lumbar]  vertebra  ;  surrounded  in  the 
hiatus  aorticus,  close  to  ductus  thoracicus  and  Ven.  azygos  by  the 
crura  of  the  diaphragm;  in  the  cavity  of  the  abdomen  on  the  left 
side  of  Ven.  cava  inferior',  covered  by  gangl.  ccdiacum,  the  corpus 
pancreatis,  and  pars  horizontal,  infer,  duodeni,  the  left  em  ul  gent 
vein,  root  of  mesenterium,  and  lumbar  portion  of  peritoneum  (to 
the  left  below). 

572.  Anterior  azygos  branches  (these  are  the  arteries  for  the 
organs  of  digestion). 

1.  Coeliaca,  the  cceliac  axis,  half  to  one  inch  long,  four  lines  diam.  Origin  : 
at.  a  right  angle  from  the  anterior  wall  of  the  Aorta,  while  still  in  hiatus  aorti- 
cus,  close  under  artt.  phrenicce  inferr.  Position  :  behind  the  curvatura  minor 
of  the  stomach,  on  the  right  side,  of  the  Cardia,  between  the  layers  of  the 
small  omentum,  upon  the  superior  border  of  the  Pancreas,  under  the  left 
lateral  part  of  the  lobul.  Spigelii,  closely  surrounded  with  plexus  cceliactis. 
Branches  pass  off  from  a  single  point  (tripus  Halleri),\o  Stomach,  Liver,  and 
Spleen  (all  lying  above  mesocolon  transvers.) 

1.  Coronaria  ventriculi  sinistra,  the  smallest  of  the  branches  of  the  cceliaca. 
Course  :  to  the  left  and  above  to  the  right  side  of  the  cardia,  then  again 
curves  to  the  right,  passes  in  the  semicircle  on  the  small  curvature  (be- 
tween the  layers  of  the  small  omentum),  and  anastomoses  with  art.  cor. 
vent,  dextr.  hepaticce.     Branches :  artt.  cesophagea  inferr.  to  the  inferior 
portion  of  the  oesophagus;  artt.  cardiacce  surround  the  cardia,  and  supply 
the  fundus  ventric. ;  artt.  gastricce  arise  along  the  small  curvature,  and 
supply  the  anterior  and  posterior  walls  of  the  stomach  ;  very  frequently 
a  ram.  hepaticus  (to  the  left  lobe  of  the  liver). 

2.  Hepatica.     Course:  transversely  to  the  right,  above  the  pancreas,  to  the 
right  before  the  trunk  of  the  ven.  portce,  gives  off  art.  pancreaticcs  mediae, 
and  divides  (one  to  two  lines  from  origin)  into  a  superior  and  inferior 
branch. 

a.  Ram.  hepaticus,  the  superior  branch,  passes  obliquely  forwards  to 
the  Porta,  where  it  divides  into  art.  hepat.  dext.  and  sinistra.  Posi- 
tion :  before  foram.  Winslowi  in  the  lig.  hepatico-duoden.,  below 
the  ven.  portce,  to  the  left  side  of  duct,  choledochus. 

1.  Pylorica  s.  coronaria  dextra,  a  small  branch  passes  along  the 
small  curvature  to  the  left,  supplies  the  anterior  and  posterior 
surfaces  of  the  stomach,  and  unites  with  coron.  ventric.  sinistra. 

2.  Hepatica  sinistra  passes  through  the  left  portion  of  the  Porta  to 
the  left  lobe  of  the  liver,  lobul.  quad,  and  Spigelii.    Branches 
pass  transversely. 

3.  Hepatica  dextra,  thicker,  passes,  divided  into  several  branches, 


THE  VESSELS.  323 

between  the  rami  of  the  ven.  porta  to  the  right  lobe  of  the  liver, 
gives  off  art .  cystica,  which,  with  a  branch  above  and  below  the 
gall  bladder,  passes  from  neck  to  fundus. 

b.  Ram,  gastro-duodenalis,  passes  downwards  between  the  commence- 
ment of  Duodenum  and  the  head  of  the  Pancreas,  and  from  pylorus 
along  the  great  curvature  between  the  layers  of  the  great  omentum. 
Branches : 

1.  Pancreatico-duodenalis,  passes  downwards  on  the  pars  descend, 
duodeni,  between  it  and  Pancreas,  gives  off  aftt.  pancreatic,  dex- 
trce  and  duodenales,  which  anastomose  with  jejunales  ofmesenter. 
superior. 

2.  Gastro-epiploica  dextra,  is  that  portion  of  ram.  gastro-duodenal. 
which  passes  along  the  great  curvature,  gives  branches  to  the 
anterior  and  posterior  surface  of  the  Stomach,  and  six  to  eight  rr. 
epiploici,  which  descend  between  the  laminae  of  the  great  omen- 
tum.    Anastomoses  at  the  fundus  ventriculi  with  coron.  ventric. 
sinistra. 

3.  Lienalis,  the  splenic  artery — the  largest  branch  of  the  caeliac  —  passes 
very  tortuously  along  the  superior  border  of  the  Pancreas  (in  a  sulcus)  to 
the  left,  and  enters  the  spleen  at  the  hilus  divided  into  (four  to  ten  small, . 
or  two  principal)  branches.     Situation :  behind  the  stomach. 
Lateral  branches : 

a.  Artt.  pancreatica  (four  to  six),  tolerably  large,  to  the  left  portion  of 
the  Pancreas. 

b.  Art.  gastro-epiploica  sinistra  descends  before  the  cauda  pancreat., 
behind  the  fundus  of  the  stomach,  passes  to  the  left  part  of  the  great 
curvature,  and  gives  ascending  branches  into  the  left  part  of  the  great 
omentum. 

c.  Art.  breves  (two  to  six),  arise  from  one  or  several  terminal  branches 
close  to  the  Spleen,  and  pass  backwards  to  the  fundus,  as  high  up- 
wards as  the  cardia  of  the  Stomach. 

2.  Mesenterica  8.  mesaraica  superior  (seven  to  eight  inches  long)  supplies  the 
small  intestines  and  the  right  half  of  the  large.  Or. :  close  (one  inch)  below 
cceliaca.  Course :  between  the  laminae  of  the  mesentery  in  the  root,  ap  far 
downwards  as  the  right  iliac  fossa,  a  little  to  the  left  and  below  curved ;  it  is 
lost,  becoming  very  small  in  the  ccecal  region. 

Situation :  at  first  behind  Pancreas,  between  it  and  Aorta,  then  separated 
from  this  by  the  boundary  bet  ween  duodenum  and  jejunum,  as  it  enters  below 
the  Pancreas  into  the  root  of  the  mesentery.  Branches  for  Pancreas;  for  the 
small  intestines  from  the  left  convex,  for  colon  and  coicum  from  the  right  con- 
cave side. 

1.  Artt.  intestinales  (s.  jejunales  et  t'Zete),  ten  to  fifteen  larger  (eight  to 
twelve  smaller)  branches,  which  pass  downwards  and  forwards  for  two 
to  three  inches  in  length,  then  divide  and  unite  in  loops  or  arches  with 
one  another.  After  a  threefold  division  and  junction,  branches  pass  off 


324  SPECIAL  ANATOMY. 

from  the  convexity  of  the  last  loops,  which  form  a  superficial  vascular  rete 
(under  the  peritoneal  investment)  and  a  deep  upon  the  mucous  membrane 
of  (fifteen  to  twenty  feet  long)  the  small  intestines.  From  one  artery 
arises  in  the  embryo  (two  to  three  months)  the 

Art.  omphalo-mesaraica,  which  passes  from  the  abdomen  through  the 
umbilical  cord  into  the  umbilical  vesicle,  and  afterwards  becomes  imper- 
vious. 

2.  Artt.  coliccB  pass  from  the  mesenterium  into  the  mesocolon,  divide  in  the 
neighbourhood  of  the  large  intestines,  and  unite  in  larger  arches,  from 
which  anterior  and  posterior  branches  immediately  come  off;  the  superfi- 
cial and  deep  ramusculi  of  which  supply  the  parietes  of  the  large  intes- 
tine.    There  are : 

a.  Art.  colica  dextra  superior,  passes  downwards  to  colon  ascendens, 
and  anastomoses  by  means  of  an  ascending  branch  with  a.  colica  me- 
dia, by  a  descending  branch  with  a.  colica  dext.  inferior. 

b.  Art.  colica  dextra  inferior,  s.  ileo-colica,  arises  deeper,  about  the 
centre  of  mesenterica  superior;  passes  downwards,  and  gives  an  as- 
cending branch  to  colon  ascendens  (which  anastomoses  with  a.) ;  a 
descending  to  caecum  (art.  ccecalis)  and  ileum  (which  anastomoses  with 
the  termination  ofmesentef  sup.  itself);  and  art.  appendicalis  for  the 
vermiform  process  of  the  caecum. 

c.  Art.  colica  media,  arises  above  from  mesent.  super,  passes  forwards 
to  the  colon  transversnm,  and  anastomoses,  with  art.  colica  dextra,  and 
to  the  left  with  art.  colica  sinistra. 

3.  Mesenterica  inferior,  smaller  than  art.  mesent.  super.,  supplies  the  left 
half  of  the  large  intestines.    Or. :  about  two  inches  above  the  place  of  bifurca- 
tion of  the  Aorta.     Course  :  at  first  downwards  upon  the  Aorta;  then  before 
the  A.  Uiaca  com.  sinistra  downwards,  and  to  the  left  in  the  mesocolon  de- 
scendens;  it  divides  two  inches  from  the  origin,  into : 

1.  Colica  sinistra  superior,  passes  transversely  outwards  before  the  left 
art .  spermat.  and  ureter,  then  behind  the  colon  sinistrum  and  peritoneum 
upwards,  divides  into  a  superior  and  inferior  arched  branch,  and  supplies 
colon  sinistr.  as  far  asflexura  sigmoidea. 

2.  Colica  sinistra  inferior,  supplies  thefiexur.  sigmoidea. 

3.  Hamorrhoidalis  superior  s.  interna,  descends  in  the  meso-rectum  to  the 
rectum  and  on  its  posterior  wall  to  the  sphincter  ani,  where  it  anasto- 
moses with  hcemorrhoidahs  media  (from  A.  hypogastr.)  and  the  vesical  ar- 
tery. 

573.         The  lateral  branches  of  the  Abdominal  Aorta, 
given  off  in  pairs. 

4.  Phrenica  inferior,  one  on  either  side,  arise  close  under  hiatus  aorticus 
(frequently  from  a.  cceliaca,  or  from  a  common  trunk),  pass  upwards  and  out- 
wards, spread  about  the  hiatus  aortic.,  foram.  quadrilat.,  and  reaches  with  an 
external  branch  to  the  attachments  of  the  diaphragm,  where  it  anastomoses 
with  artt.  intercostal,  and  mammariaint.;  it  gives  off 


THE  VESSELS.  325 

Artt.  suprarenales  superiores  for  the  caps,  suprarenales. 

5.  Suprarenales  medics  pass  before  the  crura  of  the  diaphragm  transversely 
outwards  (the  right  behind  ven.  card),  and  spread  out  upon  both  surfaces  of 
the  suprarenal  capsules. 

6.  Eenales,  short  and  thick,  sometimes  two  to  four  (emulgentes).     Or. :  at 
a  right  angle  close  under  mesenterica  super.,  frequently  deeper.      Course  : 
transversely  outwards  and  backwards  to  the  hilus  of  the  kidney.     Position : 
surrounded  by  fat,  behind  the  peritoneum  and  the  F.  renalis,  before  the  body 
of  the  second  lumbar  vertebra,  before  the  crura  of  the  diaphragm  and  Psoas 
major.     The  right  passes  behind  F.  cava.  infer.,  and  is  also  longer  than  the 
left,  which  arises  higher.    Branches : 

a.  Artt.  suprarenales  infer,  for  the  suprarenal  capsules  and  adipose  tissue 
(artt.  adiposce). 

b.  Three  to  six  terminal  branches  pass  through  the  hilus,  before  the  renal 
pelvis  and  behind  the  veins,  and  form,  between  the  cortical  and  tubular 
substance,  a  rete  which  especially  supplies  the  cortical  substance. 

7.  Spermatica  interna.     Or. :  at  an  acute  angle  from  the  anterior  wall  of  the 
aorta,  under  art.  renalis  (rarely  above,  rarely  from  this).     Course:  descends 
on  the  inner  side  of  F.  spermat.  backwards  as  far  as  the  pelvis,  behind  the  pe- 
ritoneum, before  psoas  and  ureter;  the  right  obliquely  before  F.  cava,  the  left 
before  the  sigmoid  flexure  of  colon.     Within  the  pelvis,  internal  to  psoas,  be- 
fore A.  iliac,  externa. 

In  the  male :  it  extends  through  the  inguinal  canal  (together  with  Vat  de- 
ferens;  and  Vv.  spermaticce)  to  the  testicle  and  epididymis. 

In  the  female  :  very  tortuous,  between  the  layers  of  the  lig.  uteri  latum 
below  the  ovaria,  it  anastomoses  with  art.  uterina,  gives  small  branches  to 
lig.  uteri  latum  and  the  ovary. 

8.  Lumbales  (three),  five  on  either  side.     Origin :  at  a  right  angle  from  the 
posterior  circumference  of  aorta  before  the  lumbar  vertebras.     Course:  (like 
artt.  intercostales)  transversely  outwards,  behind  the  crura  of  the  diaphragm 
(the  superior),  behind  m.  psoas  (the  inferior);  on  the  basis  proc.  transvers., 
dividing  into : 

a.  Earn,  posterior,  passes  with  a  ram.  spinalis  through  foram.  intervertebrale, 
partly  to  the  bodies  of  the  vertebrae,  partly  to  the  spinal  marrow;  with  a 
ram.  dorsalis  to  the  muscles  and  skin  of  the  lumbar  region. 

b.  Earn,  anterior.  8.  abdominalis,  smaller,  passes  between  quadrat,  lumbar. 
and  transvers.  abdom.  to  the  abdominal  muscles ;  the  branch  of  the  first  art. 
lumbalis  along  the  lower  border  of  the  twelfth  rib  obliquely  forwards ;  the 
branches  of  the  fifth  art.  lumbalis  along  the  crista  oss.  ilei,  supplies  the  abdo- 
minal muscles,  iliacus  and  glutcei. 

574.     At  the  inferior  extremity  of  the  Abdominal  Aorta, 
the  single. 

9.  Sacra  media,  small.     Or. :  close  above  or  at  the  point  of  bifurcation  from 
the  posterior  wall  of  the  aorta.    Course :  vertically  downwards,  before  the 


32d  SPECIAL  ANATOMY. 

fifth  lumbar  vertebra,  the  sacrum  coccyx,  behind  the  rectum.  Branches :  pass  off 
laterally  over  the  separate  vertebras  to  the  bones  and  periosteum,  and  anas- 
tomose with  artt.  sacrce  laterales  ;  on  the  basis  of  coccyx  arched. 

575.  C.  Iliaca  communes,  the  common  Iliac  arteries. 

Origin :  before  the  fourth  lumbar  vertebra  these  two  principal 
trunks  pass  off  from  the  anterior  wall  of  aorta  abdominalis,  at  an 
acute  angle  (in  the  male=65°,  in  the  female=75°).  Course : 
extending,  downwards  and  outwards  and  rather  backwards,  about 
two  inches  long ;  between  them  a  triangular  space,  the  base  of 
which  is  situated  at  the  inferior  border  of  the  fifth  lumbar  vertebra. 
Position:  behind  the  peritoneum  and  ureter  (crossing  with  the 
last),  on  the  inner  side  of  m.  psoas,  on  the  left  side  of  Vv.  iliacce 
communes  ;  surrounded  by  lymphatic  glands.  The  right  passes 
over  V.  iliac,  commun.  sinistra  to  the  inner  side  of  V.  iliac, 
commun.  dextra.  The  left  passes  from  the  commencement  on  the 
left  (external)  side  of  the  vein,  and  is  in  front  covered  by  Art. 
hcemorrhoidalis  interna.  Branches :  '  small  to  the  Vv.  iliacce, 
communes  and  .lymphatic  glands,  otherwise  none.  Each  Art. 
iliac,  commun.  divides  rather  above  Symphysis  sacro-iliaca 
into  two  terminal  branches :  Art.  hypogastrica  and  cruralis. 

576.  I.  Hypogastrica  s.  Iliaca  interna,  the  internal  Iliac  artery, 

the  internal  branch  of  iliaca  com mun.,  passes  at  first  rather  down- 
wards and  forwards,  then  slightly  curved,  before  symphysis  sacro- 
iliaca  into  the  small  pelvis,  and  divides,  after  a  course  of  an  inch 
to  an  inch  and  a  half,  either  into  two  (an  anterior  arid  a  posterior) 
or  into  eight  (in  the  female  ten)  branches.  Position  :  behind  the 
peritoneum,  on  the  left  side  the  Vv.  hypogastr.,  A.  hypog.  sinistra 
passes  over  V.  iliaca  com.  sinistra,  inwards. 

577.  Anterior  branches  : 

1.  Umbilicalis,  the  umbilical  artery  of  the  embryo.  Vesicalis,  the  vesical 
artery  of  adults. 

The  umbilical  arteries,  very  large  in  the  embryo,  the  blood  of  which  they 
carry  to  the  placenta,  pass  downwards,  curved  forwards  and  outwards,  to  the 
sides  of  the  urinary  bladder,  upwards  and  inwards  to  the  umbilical  ring,  from 
which  they  pass  out  into  the  umbilical  cord  and  placenta,  winding  round  the 
Vena  umbilicalis  spirally.  After  birth  the  portion  between  the  naval  and 
urinary  bladder  is  closed,  and  froms  the  lig.  laterals  vesicce.  From  which 
piece,  still  open  and  with  thick  walls  (art.  veswalis)  arise: 

1.  Artt.  vesicales.  a.  Posterior  on  the  posterior  Wall  of  the  bladder  from  the 
base  to  the  vertex,  b.  Anterior  on  the  anterior  surface,  often  arises  from 


THE  VESSELS.  327 

art.  uterina.     c.  Inferior,  often  from  Art.  hypogastrica  ;  at  the  base  of  the 
bladder  it  also  supplies  the  seminal  vesicles. 

2.  Art.  uterina  arises  frequently  from  the  hypogastric.,  passes  transversely 
inwards,  curves  from  the  external  border  of  collum  uteri  into  lig.  latum,  at 
the  sides  of  the  uterus  up  to  ihefundus,  supplying  with  several  anastomo- 
sing branches  the  anterior  and  posterior  surfaces  of  the  uterus,  and  penetra- 
ting into  its  substance.    All  these  are  very  tortuous,  and  particularly  deve- 
loped during   pregnancy.    Branches:    tubaria  passes  with  three   long 
branches  to  the  fimbriae  and  Fallopian  tubes,  giving  off  the  proper  ovarica. 

3.  Art.  vaginalis  descends  on  the  side  of  the  uterus,  supplies  this  with  many 
branches,  also  with  a  branch  for  the  neck  of  the  bladder,  and  terminates 
in  an  arch  between  vagina  and  rectum. 

4.  Art .  defer  entialis,  generally  from  vesicalis  inferior  to  the  seminal  vesicles 
and  vas  deferens,  and  art.  (vesico)  prostatica  to  the  pars  prostatica  urethra. 

5.  Art.  hamorrhoidalis  media,  sometimes  wanting,  or  arises  from  art.  hypo- 
gastr.  and  pudenda  interna  ;  passes  laterally  on  the  anterior  surface  of  the 
rectum. 

2.  Obturatoria.     Origin:  below  the  umbilicalis  from  the  hypogastr.,  often 
from  iliaca  externa  (rarely  from  a.  cruralis),  and  in  common  with  a.  epigas- 
trica.     Course:  horizontally  forwards,  on  the  lateral  wall  of  the  entrance  to 
the  pelvis,  as  far  as  and  through  (the  superior  angle  of  the)  foram.  ovale  out 
upon  the  thigh,  where  it  divides  into  an  external  and  internal  branch.    Posi- 
tion: close  under  m.  psoas,  above  nerv.  obturator,  behind  the  peritoneum. 

Lateral  branches  in  the  pelvis  : 

a.  Earn,  iliacus  passes  forwards  between/ossa  and  m.  iliacus  ;  anastomoses 
wilh  circumflexa  ilei. 

b.  Sam.  pubicus  arches  behind  the  symphy.  pubis. 

c.  Sam.  ascendens  small,  anastomoses  with  epigastrica. 
Terminal  branches  outside  the  pelvis : 

d.  Ram.  interior  s.  internus,  between  m.  obturat.    extern,   and   os  pubis, 
arched  on  the  inner  half  of  foram.  obturat.  downwards  and  backwards  ; 
it  gives  branches  to  mm.  adductores  ;  to  the  scrotum  (in  the  female  to 

•    labia  externa)  ;  anastomoses  with  art.  circumflex,  interna. 

c.  Ram.  posterior  s.  externus,  on  the  outer  half  of  foram.  obtur.,  terminates 
between  the  neck  of  the  femur  and  m.  quadratus,  by  means  of  anastomoses 
with  art.  ischiadica  ;  it  gives  art.  acetabuli  (to  the  fat  in  the  depth  of  the 
acftabulum). 

578.          Posterior  branches  of  the  hypogastrica  : 

3.  lleo-lumbalis  s.  iliaca  anterior.      Origin :    sometimes  with  art.  glutaa 
from  the  posterior  wall,  next  to  the  origin  of  hypogastrica.     Course :  back- 
wards and  behind  n.  obturatorius,  external  and  superior  to  the  upper  border 
of  the  Sacrum;  behind  m.  psoas;  divides  immediately  into : 

a.  Earn,  lumbalis,  which  ascends  along  the  bodies  of  the  lumbar  vertebras 


328  SPECIAL  ANATOMY. 

behind  m.  psoas,  gives  off  a  muscular  branch  for  m.  psoas  and  quadrat, 
lumborum,  and  a  spinal  branch  through  foram.  intervert.,  between  the 
last  lumbar  vertebrae  and  sacrum  to  the  spinal  cord. 

b.  Ram.  iliacus;  passes  transversely  outwards  upon  the  fossa,  iliaca,  with  a 
superficial  branch  on  the  inner,  with  a  deep  on  the  outer  surface  of  the 
Iliacus,  and  supplies  the  muscles  of  the  periosteum. 

4.  Sacra  lateralis;  very  frequently  two  on  either  side.     Origin:  frequently 
from  art.  glutcsa.     Course :  inwards  and  downwards,  on  the  anterior  surface 
of  the  Sacrum  (external  to  the  foram.  sacralia  anterr.):  anastomoses  in  front 
with  sacra  media,  and  gives  branches  to  the  posterior  internal  bony  walls. 
Besides  these  :  rami  spinales,  which  enter  through  foramen  sacralia  anterr. 
into  the  canalis  spinalis  to  the  nerves,  and  through/orr.  sacrr.  posterr.  to  the 
spinal  muscles. 

5.  Glutcea  (superior)  s.  iliaca  posterior,  the  glutasal  artery.     The  largest 
branch  of  the  hypogastrica  passes  out  from  the  pelvis,  curving  backwards  and 
outwards:   passes  between  the  first  sacral  and  fifth  lumbar  nerves  to  the 
highest  part  of  incisura  ischiadica,  above  the  superior  border  of  m.  pyriformis, 
and  immediately  divides  into   a  superficial   branch,   which  ramifies  under 
glutceus  maximus  on  the  posterior  and  superior  part  of  it,  and  into  a  deeper 
branch,  which  passes  between  m.  glutceus  med.  and  minimus  on  the  superior 
border  forwards  and  upwards.     Nutritia  llei  passes  inside  the  pelvis  at  the 
inferior  part  of  os  llei. 

579.          Terminal  branches  of  the  hypogastrica  : 

6.  Ischiadica  s.  glutcea  inferior.     Origin  :  often  in  common  with  glutcea  or 
pudenda  interna.     Course  :  before  the  glutcea;  passes  out  of  the  pelvis  under 
m.  pyriformis,  and  above  lig.  sacro-spinosum  through   incisura  ischiadica. 
Position:  on  the  inner  side  of  N.  Ischiad.,  behind  the  pudenda.     Branches: 
internal  pass  transversely  between  m.  glutceus  max.  and  lig.  tuberosa  sacrum, 
and  to  the   skin  of  the  coccyx;    several  descend  with  IV.  Ischiad.,  others 
to  the  rotator  muscles ;  anastomoses  with  art.  circumjlexa  ilii,  behind  collum 
femoris. 

7.  Pudenda  (communis  s.  pudica  interna).      Course  :  passes  out  before  the 
plexus  sacral,  downwards,  between  m.  pyriform.  (below  it)  and  lig.  spinoso- 
sacrum  from  the  incis.  ischiad.  major,  turns  round  the  external  surface  of  the 
Spina,  and  passes  between  lig.  sacro-spinos.  and  tuberosum  through   incis. 
ischiadic.  minor  again  within  the  pelvis  ;  then  ascends  on  the  inner  surface  of 
tuber  Ischii,  the  rami  of  the  ischia  and  pubis,  as  high  as  the  symphysis  pubis; 
at  that  place  lying  close  to  the  bones  upon  m.  trans,  perincei  and  ischio -caver •• 
nosus.     Branches:  small  for  the  urinary  bladder,  rectum,  vesiculas  seminales, 
Prostata  or  Vagina ;  close  to  the  spina  ischii  branches  to  the  rotator  muscles  ; 
on  the  tuber  Ischii  external  muscular  branches,  and  an  anastomosis  with  art- 
ischiad.  between  tuber  Ischii  and  trochanter;  the  internal  are  : 

a.  Artt.  hcemorrhoidales  infer,  s.  externce  for  the  rectum,  sphincter,  and  leva- 
tor  ani. 


THE  VESSELS.  329 

Terminal  branches  :  b.  Perineea  (super jicialis).  Or. :  at  the  posterior 
border  of  m.  trans,  perincei.  Course  :  from  behind  forwards,  and  from  with- 
out inwards  on  the  inner  side  of  m.  ischio-cavernos.,  and  terminates  in  the 
centre  of  the  scrotum  as  art.  septi  scroll.  Position :  above  fasc.  perincei 
superficialis,  below,  m.  transfers,  perincei  superf.  Branches:  transversa 
perinai  passes  behind  transversely  over  the  perinceum;  scrotales  posteriores  s. 
labiales,  at  the  termination  of  the  perinceum  to  the  posterior  part  of  the  scrotum 
or  labia. 

c.  Profunda  perincsi  8.  art.  penis  (ditoridis)  is  the  name  also  given  to  that 
part  of  the  pudenda  from  the  posterior  border  of  m.  transvers.  perin.  as  far  as 
symphys.  pubis.  From  it  pass  off: 

a.  Bulbosa  s.  bulbi  urethras,  a  large  branch,  transversely  to  the  posterior 
boundary  of  bulbus  urethra;  (or  to  the  Vagina  [the  nymphos] ),  ramifying 
in  corp.  cavernos.  [spongiosum]  urethra  to  the  glans. 

b.  Dorsalis  penis  (or  ditoridis)  perforates  between  the  roots  of  the  corp. 
cavernos.  and  the  symphys.  pub.,  the  ligam.  suspensor.,  passes  close  be- 
neath the  skin  very  tortuously  upon  the  back  of  the  penis  to  the  glans, 
behind  which  it  forms  a  vascular  circle,  and  supplies  the  foreskin  and 
glans. 

c.  Cavernosa  s.  profunda  penis  (or  ditoridis)  passes  in  the  middle  of  the 
cavernous  body  along  the  septum,  and  ramifies  very  delicately  inside  it, 
as  far  as  the  glans,  anastomosing  with  the  bulbosa  and  dorsal,  pen.,  and 
that  of  the  other  side  through  the  septum.     J.  Miiller's  Artt.  helicince, 
the  tendril-like  tortuous  capillary  vessels  of  cavernosa,  which  terminate 
blindly,  and  are  said  to  give  rise  to  the  erectio  penis,  are  probably  artifi- 
cial anatomical  products.     (Henle.) 

580.  II.  Cruralis,  the  external  Iliac  artery, 

the  external  branch  of  Iliaca  communis,  passes  from  the  place  of 
division  of  the  last  in  the  pelvis,  as  Art.  Iliaca  externa,  on  to  the 
thigh,  as :  femoralis,  as  far  as  the  popliteal  space,  where  it  is 
called  poplitcea. 

581.  A.  Iliaca  externa. 

Origin  :  before  the  superior  border  of  symphysis  sacro-iliaca 
from  art.  iliaca  communis.  Termination  :  at  the  femoral  arch 
in  the  centre  between  symphysis  pubis  and  spina  ilei  super. 
Length:  three  and  a  half  inches.  Course:  extends  obliquely 
from  above  downwards,  from  within  outwards,  and  rather  for- 
wards, into  the  pelvis.  Position  :  covered  before  and  internally, 
loosely,  by  peritoneum;  crossed  by  the  ureter;  separated  from 
it  on  the  inner  side  of  the  m.  psoas  by  fasc.  iliaca  ;  before  ven. 
iliaca  externa.  Before  the  right  art.  iliaca  rests  the  termination 
of  the  small  intestines;  before  the  left  the  sigmoid  flexure  of 


330  SPECIAL  ANATOMY. 

colon.  Behind  the  ligam.  Pouparti,  it  is  situated  on  the  outer 
side  of  the  vein  (in  the  same  sheath  with  it),  on  the  inner  side  of 
nerv.  cruralis.  Branches  : 

1.  Epigastrica  (inferior  s.  interna).     Origin  :  two  to  three  lines  (sometimes 
half  an  inch  to  two  inches  above  lig.  Pouparti  from  the  inner  side  of  lliaca 
externa,  or  in  common  with  art.  obturatoria).     Course  :  1..  at  first  transversely 
inwards  to  beneath  the  spermatic  cord  (or  lig.  rotund,  of  the  female) ;  2.  then 
bends  upwards,  concave  above ;  3.  lastly,  directly  upwards  to  the  umbilicus. 
Position  :  1.  before  Ven.  cruralis,  crossed  by  vas  deferens  which  ascends  ver- 
tically behind  it,  then  above  it  anteriorly  and  in  the  inguinal  canal ;  half  an 
inch  to  an  inch  and  a  half  (at  the  convexity  of  the  crossing  points  is  the  ab- 
normal origin  of  obturatoria,  which  then  winds  round  the  upper  and  inner 
boundary  of  the  fempral  ring) ;  2.  obliquely  behind  the  posterior  wall  of  in- 
guinal canal,  upwards  and  inwards,  between  fasc.  transversa  and  peritoneum, 
it  forms  the  boundary  between  fovea  inguinal,  externa  and  interna;  3.  at  the 
outer  border  and  the  posterior  surface  (inside  the  sheath)  of  m,  rectusabdominis. 
It  is  lost  in  the  umbilical  region,  as  it  anastomoses. with  A.  mammar.  intern. 
by  means  of  a  capillary  rete  inside  the  m.  rectus.    Branches  : 

a.  Art.  spermatica  externa,  enters  the.  inguinal  canal,   passes  through  it 
along  the  anterior  surface  of  the  spermatic  cord  (lig.  uteri  rotundum), 
and  passes  to  the  scrotum  (labia  majora}  outwards;  anastomoses  with 
spermat.  interna. 

b.  Art.  pubica,  passes  along  the  crista  oss.  pubis  internally,  where  it  anasto- 
moses, behind  the  Syniphysis,  with  the  artery  of  the  other  side. 

c.  Ram.  obturatorius,  descends  on  the  superior  and  internal  border  of  the 
femoral  ring  behind  the  ram.  horizontal,  oss.  pubis  tp  art.  obturator.  ;  is 
sometimes  so  large  that  the  art.  obturatoria  appears  to  arise  from  art.  epi~ 
gastrica. 

2.  Circumjlexa  ilii  s.  epigastrica  externa.     Origin:  opposite  to  the  last,  or 
below  it,  from  the  outer  side  of  the  art.  iliaca  ext.;  sometimes  double.  Course : 
obliquely  outwards  and  upwards  to  the  spina  ilei  anterior  superior,  hence 
arched  along  the  crista  oss.  ilei,  between  m.  obliq.   intern,  and  transfers, 
abdom.  to  the  art.  ileo-lumbalis  backwards.     Position :  at  first  behind  ligam. 
Poupartii.  bet  ween  the  two  laminae  of  fasc.  iliaca,  then  only  covered  by  the 
peritoneum.     Branches :  ascending  for  the  abdominal  muscles  and  skin  ;  de- 
scending for  the  fossa  iliaca.     In  the  region  of  the  Spina  the 

Ram.  abdominalis  ascends,  parallel  with  the  art .  epigastrica,  between  m. 
transversus  and  obliquus  internus,  and  anastomoses  with  artt.  lumbales 
and  intercost.  inferr. 

582.  B.  Femoralis,  the  femoral  artery, 

is  that  part  of  art.  cruralis  which  reaches  from  the  femoral  ring  to 
the  inferior  third  of  the  thigh,  passing  downwards,  inwards  and  a 
little  backwards,  in.  the  direction  of  a  line  which  commences  in 


THE  VESSELS.  331 

the  centre  between  spina  ilei  anter.  superior  and  symphysispubis> 
and  terminates  on  the  inner  side  of  the  limb,  below  its  middle. 
Position  :  for  about  three  inches  below  Poupart's  ligament  the  ar- 
tery is  covered  in  front  by  the  skin,  fasc.  lota  and  lymphatic  glands, 
then  by  m.  sartorius,  which  passes  obliquely  from  above  down- 
wards and  from  without  inwards,  and  inclines  to  the  inner  side  of 
vastus  intern,  in  the  groove  between  this  and  the  insertions  of  the 
Adductores.  Behind  it  rests  in  a  groove  between  m.  psoas  (with- 
out) and  pectinceus  (within),  upon  the  body  of  the  os  pubis,  the 
emimntm  ileo-pectincBa,  before  the  internal  third  of  the  acetabulum, 
so  that  a  space  of  from  one  inch  to  one  and  a  half  is  found  between 
it  and  the  superior  part  of  the  os  femor.,  farther  down  upon  the 
adductor  magnus,  the  tendon  of  which  it  perforates,  and  passes 
upon  the  posterior  surface  of  the  thigh.  Above,  the  vein  lies  to 
the  inner,  farther  down  on  the  posterior  side ;  the  nerve  on  the 
outer  side  of  the  artery.  The  art.  and  ven.femor.  lie  in  a  proper 
sheath,  into  which  n.  sapfon.  internus  penetrates,  whilst  nerv.  cru- 
ralis  remains  in  its  own  sheath.  Branches : 

1.  Inguinales,  three  to  six,  small,  arise  in  front  close  under  lig.  Poupart. ; 
they  ramify  in  the  glands  and  skin  of  the  groin. 

2.  Epigastrica  superficialis,  arises  one  inch  below  the  femoral  arch,  in  front, 
perforates  proc.  falciform.,  passes  vertically  upwards,  between  the  skin  and 
fasc.  superficialis,  gives  a  transverse  ram.  iliacus  inwards  towards  the  spina 

ilei,  and  terminates  at  the  umbilicus,  in  the  skin. 

3.  Pudenda  externa  (scrotales  or  labiales  anteriores),  usually  a  superior  and 
an  inferior ;  they  pass  from  arcus  cruralis  transversely  inwards  ;  the  superior 
close  under  the  skin  to  the  mons  Veneris,  penis  and  scrotum  (or  labia  majora); 
the  inferior  covered  by  ihe  fascia,  transversely  before  Ven.  crural.,  under  ven. 
saphena. 

4.  Profundafemoris,  supplies  the  muscles  and  skin  on  the  inner  and  poste- 
rior surface  of  the  thigh.     Origin:  H  to  2  inches  below  the  femoral  arch, 
sometimes  also  higher,  rarely  deeper.     Course :    immediately  backwards, 
then  downwards  between  mm.  adductores,  closer  to  the  bone  than  art.femo- 
ralis,  perforates  the  adductor  magn.  (above  the  perforation  for  femo falls') ,  and 
is  lost  in  biceps  and  semitendinosus.     Position  :  above  before  the  termination 
of 'flexor,  femoris  and  pectinaus,  lastly  adductor  magnus  and  brevis,  behind  ad- 
ductor longus. 

Branches :  1.  The  circumflex  arteries,  two. 

2.  The  perforating  arteries,  three  to  five. 

1.  Circumflexa  femoris  interna,  arises  £  to  1  inch  below  the  commencement 
of  prof,  femo  r.;  passes  backwards  and  transversely  inwards  between  m.  pecti- 
n&us  and  flexor,  femor.,  above  trochant er  minor,  to  the 

internal  and  posterior  surface  of  the  neck  of  the  femur.    Branches :  ram. 
superficial,  to  m.  pectinaus,  abduct,  long,  and  brevis. 


332  SPECIAL  ANATOMY. 

Art.  acetabuli  to  the  capsule  and  lig.  teres  of  the  acetabulum. 

Earn,  anastomotici  to  the  superior  part  of  the  scrotum,  uniting  with  the 

obturatoria  and  pudenda. 
Ram.  trochantericus,  between  m.  obturat.  ext.  and  quadrat,  femor.,  to  the 

fossa  of  trochanter  major,  anastomosing  with  glutcea  and  ischiadica. 

2.  Circumflexa  femoris  externa,  passes  behind  m.  rectus  femor.,  before  Psoas- 
iliacus  outwards  around  the  basis  of  trochanter  major,  and  there  ramifies,  since 
it  anastomoses  with  the  interna,  sends  a  branch  upwards  for  glutceus  minim. 
and  fascia  lata,  another  on  the  outer  border  of  red.  femoris  downwards  al- 
most as  far  as  the  patella. 

3.  Perforantes,  three  to  five  ;  they  perforate  the  mm.  adductores  at  their  in- 
sertions, and  then  pass  to  the  posterior  surface  transversely  round  the  femur, 
and  supply  the  muscles  on  the  posterior  surface  of  the  limb.  Art .  perfor.  prima 
perforates  the  adductor  magnus  below  the  trochanter  minor,  gives  a  branch  to 
n.  ischiadicus  and  a  nutritia  femoris  superior  ;  nutritia  magna  comes  from  the 
second  or  third  art.  perforans,  [and  takes  a  direction  upwards].    They  anas- 
tomose with  the  inferior  branches  of  femoralis  (also  keep  up  the  collateral 
circulation  after  ligature  of  the  poplitcea).     The  first  also  anastomoses  with 
the  circumflex,  femor.  and  glutcea  ;  the  third  is  the  terminal  branch  of  pro- 
fundafemoris. 

083.  C.  Poplitcea,  the  popliteal  artery, 

the  continuation  of  art.  femoralis,  reaches,  from  the  inferior  third 
or  fourth  of  the  thigh,  as  far  as  to  the  superior  fifth  or  sixth  of  the 
leg,  and  is  about  seven  inches  long.  Course :  somewhat  oblique, 
from  above,  downwards,  and  from  within,  outwards  to  the  centre 
of  the  popliteal  region,  hence,  vertically  downwards.  Position : 
deep,  (especially  below)  in  the  neighbourhood  of  the  bone,  it  is 
covered  behind — from  above  to  below  by  :  m.  semi-membranos., 
fat  and  fascia  poplitcea  ;  m.  gastrocnemius  and  plantaris  long., 
lastly  m.  soleus  ;  close  behind  it,  and  externally  (almost  together) 
Ven.  poplitcea,  and  behind  this  N.  tibialis.  Before  it  lie — from 
above  downwards — the  inner  and  posterior  surface  of  the  os  fe- 
moris, the  knee-joint  and  m.  poplitceus.  On  the  inner  side  :  m. 
semi-membran.,  condyl.  intern,  femor.,  caput  intern,  gastrocnemii. 
-On  the  outer  side :  m.  biceps,  cap.  extern,  gastrocn.,  plantar,  long., 
soleus.  Branches  ;  posterior : 

1.  Surales  8.  gemellce,  two  to  four,  arise  at  the  knee-joint,  pass  forwards  and 
downwards  on  the  anterior  internal  surface  ofm.  gastrocnemius;  a  branch  with 
n.  saphenus  as  far  as  tendo  Achittis.     Anterior  branches : 

2.  Articulares  genu  superiores,  superior  articular  arteries. 

a.  Articularis  interna  I.,  a.  superficialis  [s.  anastomotica  magna]  arises 
from  art.  cruralis  whilst  in  the  sheath  of  m.  adduct.  magn.,  sometimes 
higher  ;  the  largest  passes  under  sartorius  to  the  condylus  internus;  a 
branch  to  the  triceps,  another  with  n.  saphenus  intern. 


. 

THE  VESSELS.  333 

b.  Articularis  internet  II. ,  passes  transversely  to  the  condylus  internus, 
ramifies  there  and  gives  branches  to  the  border  of  the  patella. 

c.  Articularis  externa  arises  opposite  6,  and  passes  transversely  outwards 
to  condyl.  externus,  and  gives  an  : 

Art.— superior  media  for  the  posterior  surface  of  the  knee-joint. 
3.  Articulares  genu  inferiores,  inferior  articular  arteries. 

d.  Articularis  externa,  passes  outwards  and  forwards  above  the  fibula, 
covered  by  gastrocn.  extern.,  plantar,  long.,  biceps,  andlig.  genu  extern. 

e.  Articularis  interna,  also  passes  inwards  to  the  condyl.  tibia.     From  it, 
if  not  from  the  art.  poplit.  itself,  arises  : 

Art. — inferior  media,  which  penetrates  from  behind  through  the 
middle  of  the  capsular  ligament  into  the  knee-joint. 

f.  Articularis  iiifima  externa,  passes  transversely  over  the  fibula  out- 
wards, covered  by  m.  peronoeus  long,  and  extens.  digit,  commun.,  rami- 
fying in  these  as  far  as  the  fibula  and  knee-joint. 

Sete  articulare  genu,  is  found  on  the  anterior  and  lateral  surfaces  of  the 
knee-joint,  and  behind  lig.  patella.  It  is  formed  by  artt.  articulares  genu, 
connected  above  with  the  perforantes  profundcefemor.,  below  with  the  recur- 
rentes  tibice. 

584.     HI.   Tibialis  antica,  the  anterior  tibial  artery, 

the  anterior  branch  of  art.  poplitcea  (two  or  three  inches  below  the 
knee-joint),  passes,  from  the  point  of  division  of  the  last  at  the  in- 
ferior border  of  m.  paplitaus,  immediately  forwards  above  the  su- 
perior border  of  lig.  interosseum  (between  the  superior  extremity 
of  tibia  and  fibula).  It  then  extends  directly  downwards  before 
lig.  inteross.  as  far  as  the  inferior  fourth  of  the  tibia,  thence  in- 
clines inwards  and  downwards  to  the  dorsum  of  the  foot,  from 
which  point  it  is  called  art.  pedicea.  Position :  very  deep,  before 
lig.  interosseum,  and  farther  down  before  the  external  surface  of 
the  tibia,  behind  and  between  m.  tibialis  anticus  and  extensores 
digit,  (commun.  and  hattuc.  long.) ;  on  the  inner  side  of  the  n. 
tibial.  anticus.  At  the  tarsal  joint :  upon  this,  covered  by  lig. 
cruciat.  and  the  tendons  of  extens.  hattuc.  longus. — Branches : 

1.  Recurrens  tibialis  posterior,  passes  off  close  at  the  commencement  of 
tibialis,  upon  the  posterior  surface  of  the  tibia  upwards  to  the  joint ;  covered 
by  m.  poplitceus. 

2.  Recurrens  tibialis  anterior. — Or. :  close  above  lig.  inteross.     Course :  in- 
wards and  upwards  between  m.  tibial.  anticus  and  condylus  extern,  tibiae,  close 
to  the  bone.   Branches  to  m.  tibial.  antic.,  extens.  digit,  comm.,  capitul.  fibul.; 
anastomoses  with  articul.  genu  extern. 

3.  Art.  malleolaris  externa,  arises  higher  or  deeper,  above  lig.  tarsi  dorsale. 
Course  :  curves  outwards  and  forwards  around  the  external  malleolus  to  the 
outer  surface  of  os  cuboideum,  and  anastomoses  with  art.  tarsea  externa  and 
perontea. 


334  SPECIAL  ANATOMY. 

4.  Art.  malleolaris  interna,  passes  transversely  under  tendo  m.  filial,  antici 
inwards   and  above  the  internal  malleolus  to  the  internal  surface  of  the 
tarsus,  and  anastomoses  with  art .  plantaris  interna. 

585.  Pedicea  s.  dorsalis  pedis,  the  dorsal  artery  of  the  foot, 

the  continuation  of  tibial.  antica,  when  it  has  passed  out  from  under  the  lig. 
tarsi  dorsale,  passes  upon  the  back  of  the  foot,  from  behind  forwards,  as  far 
as  the  posterior  extremities  of  the  os  metatarsi  1.  and  11.,  and  sinks  between 
these  to  the  sole  of  the  foot.  Position :  on  the  external  border  along  the  ten- 
dons of  extensor  halluc.  longus,  on  the  internal  of  extens.  digit,  brevis,  covered 
by  the  fascia  and  skin,  only.  Branches : 

5.  Tarsea  externa.    Origin  :  before  the  collum  astragali.   Course  :  obliquely 
outwards,  under  m.  extens.  digitorum  brevis,  to  the  basis  of  the  fifth  os  meta- 
tarsi; anastomoses  with  art.  plantaris  under  the  sole  of  the  foot. 

Branches  :  •!.  Ham.  posterior,  anastom.  with  art.  malleolar.  externa  and^e- 

roncea. 

2.  Sam.  anterior,  passes  forwards  in  a  curve,  anastomoses  with 
art.  metatarsea,  and  sometimes  gives  the  interossea  dorsalis  3. 

6.  Tarsea  interna,  passes  obliquely  forwards  and  inwards,  to  the  articula- 
tion of  os  cuneiformel.  and  metatarsi  1.,  gives  branches  to  the  great  toe  before, 
and  to  the  metatarsus  behind. 

7.  Art.  metatarsea,  arises,  generally,  in  the  interspace  between  first  and 
second  os  metatarsi  at  the  posterior  extremity ;  passes  transversely  outwards, 
and  forms  the  arcus  dorsalis  metatarsi,  which  anastomoses  with  tarsea  externa 
and  gives  off  anteriorly  the  artt.  interossece. 

8.  Art.  interossea  dorsalis  I.  passes  off  from  the  art.  pedicea,  before  this  be- 
takes itself  to  the  sole  of  the  foot,  into  first  interstit.  inteross.,  and  supplies  the. 
dorsal  surface  of  the  outer  and  inner  border  of  the  great  toe  and  the  internal 
border  of  the  second  toe ;  it  belongs  therefore  to  the  arcus  dorsalis. 

586.  IV.  Tibialis  postica,  the  posterior  tibial  artery, 

the  posterior  branch  of  art.  poplitaa,  passes  downwards  in  the 
direction  of  the  last,  at  an  acute  angle  from  art.  tibialis  antica  to 
the  posterior  surface  of  the  leg  and  the  internal  malleolus  ;  beneath 
this  to  the  groove  on .  the  inner  surface  of  calcaneus,  and  divides 
at  the  boundary  between  the  sole  and  the  internal  border  of  the 
metatarsus,  into  art.  plantaris  interna  and  externa.  .  Position : 
as  far  as  the  inferior  third  of  the  tibia  before  m.  soleus,  then  on  the 
inner  border  of  tendo  Achillis,  covered  by  the  fascia  and  skin,  only ; 
behind  m.  tibialis posticus  and  flexor,  digitor.  longus  ;  on  the  in- 
ner side  of  n.  tibialis.  On  the  inner  side  of  the  os  calcis  covered 
by  lig.  laciniat.  internum  above,  flex,  digit,  long,  (within)  and 
haUucis  (without)  it  divides,  close  behind  caro  quadrata.  Branches  : 


THE  VESSELS.  335 

1.  Nutrition  tibia,  large,  passes  downwards  on  the  posterior  and  outer  side  of 
tibia  as  far  asforam.  nutrit.,  and  supplies  the  medullary  cells. 

2.  Art.  perpntea  s.fibularis.     Origin :  at  an  acute  angle,  one  inch  to  an  inch 
and  a  half  below  the  origin,  on  the  outer  wall  of  tibial.  postica.  Course  :  down- 
wards along  the  inner  posterior  surface  of  the  fibula,  separated  from  it  by 

flexor  halluc.  long.,  and  behind  the  external  malleolus,  on  the  outer  side  of 
colcaneus.  Position  :  covered  behind  by  m.  soleus  upon  tibialis  posticus,  then 
between  this  and  flex,  halluc.  longus,  upon  lig.  interosseum.  Behind  malleolus 
externus;  on  the  external  border  of  tendo  Achillis  covered  by  fascia  and  skin, 
only. 

a.  Muscular  branches  backwards  for  m.  soleus,  externally  for  mm.  peronasi 
and  a  nutritia  flbulcs  [directed  downwards] . 

b.  Peroncea  anterior  s.  perforans,  a  thinner  branch,  passes  down  on  the 
inferior  third  of  the  tibia  through  the  lig.  interosseum  on  its  anterior 
surface,  and  passes  into  the  rete  mall-eol.  externum. 

c.  Peron&a  posterior,  a  continuation  of  art.  peronoza,  passes  along  the 
outer  border  of  the  tendo  Achillis,  covered  by  fascia  and  skin,  only,  to 
the  outer  surface  ofcalcaneus,  and  anastomoses  with  art.  malleolar.  and 
plantar,  externn.,  and  gives  a  transverse  uniting  branch  which  passes 
between  the  tendo  Achillis  and  the  bones  to  the  tibialis  postica. 

3.  Malleolaris  interna  posterior  arises  behind  the  inferior  extremity  of  tibia, 
passes  close  to  the  bone  from  the  tendons  of  tibialis  posticus  and  flex,  digit, 
long,  to  the  inner  malleolus  and  into  rete  malleolar e  internum. 

4.  Plantaris  interna,  the  smaller  internal  terminal  branch  of  art.  tibialis 
postica.     Course  :  along  the  inner  border  of  the  sole  of  the  foot  (one  inch  re- 
moved from  it)  forwards.     Position :  between  abductor  hallucis  (within)  and 
flexores  digitor.  (without),  covered  by  the  fascia  plantar. 

Branches:  ascending  to  the  articulations  of  the  metatarsal  bones.  Termi- 
nal branches  from  the  posterior  extremity  of  os  metatarsi  hallucis  : 

a.  Ram.  internus,  passes  along  the  inner  border  of  the  m.  abductor  hallucis 
superficially. 

b.  Earn,  internus,  anastomoses  with  the  trunk  of  art.  inteross.  plantar.  L 
A  branch  passes  through/asc.  plantaris  to  the  skin  of  the  inner  side. 

5.  Plantaris  extcrna,  the  deeper  external  terminal  branch  of  tibial.  postica. 
Course :  from  the  inner  side  ofcalcaneus,  obliquely  outwards  and  forwards  as 
far  as  the  posterior  extremity  of  os  metatarsi  V.;  an  inch  distant  from  the 
outer  border  of  the  foot ;  then  curved  inwards  above  oss.  metatarsi  4  to  2, 
where  it  anastomoses  with  art .  pedi&a  (see  arcus  plantaris).     Position  :  upon 
the  tendons  of  flex,  digit,  commun.  and  halluc^,  caro  quadrata^  flex,  digit.  5. 
brev.  and  inteross ei;  covered  behind  by  lig.  laciniat.,  then  by  abduct,  halluc., 
flexor  digit,  brevis,  aponeurosis  plantar,  (below). 

Branches:  to  the  calcis,  to  mm.  flexor,  digit,  brev.  and  caro  quadr.,  to  the 
Tarsus.  Art.  plantaris  digiti  V.  externa  passes  under  flex,  brevis  digit.  V., 
terminates  at  the  outer  border  of  the  plantar  surface  of  the  little  toe,  and  anas- 
tomoses with  art.  dorsales  tarsi  (compare  Arcus  plantaris  and  Art.  tarsea 
externa.) 


t 

336  SPECIAL  ANATOMY. 

587.  The  vascular  arches  of  the  foot. 

1.  Arcus  dorsalis  pedis  s.  tarseus  dorsalis,  close  upon  the  dorsal  surface  of 
the  metatarsal  bone,  is  before  convex,  and  arises  from  the  junction  of  the 

Art .  metatarsea  with  the  anterior  branch  of  the  art.  tarsea. 
From  it  three  branches  arise : 

Arlt.  interossecB  dorsalis  pass  in  the  second  to  the  fourth  interstitium  in- 
terosseum  metatarsi,  where  they  give  off  the  three  : 
Artt.  perforantes,  which  sinks  downwards,  and  pass  opposite  to  the 
artt.  perforantes  from  the  arcus  plantaris; 

whilst  they  divide  in  a  forked  manner  at  the  anterior  extremity  into  the 
small : 

Artt.  digitales  dorsales,  which  betake  themselves  to  the  dorsal  sur- 
face of  the  toes,  from  the  external  border  of  the  second  as  far  as  the 
internal  of  the  fifth  toe,  terminate  on  the  first  phalanx,  and  unite 
with  the  corresponding  of  arcus  plantaris. 

Both  borders  of  the  first  and  the  internal  border  of  the  second  toe  are 
supplied  from  art.  dorsalis  hallucis,  the  terminal  branch  of  art.  pedicea. 

2.  Arcus  plantaris  (profundus,  there  is  no  arcus  plant,  sublimis  present), 
close  under  the  posterior  extremities  of  the  metatarsal  bones  in  the  sole  of  the 
foot,  is  convex  before,  and  arises  principally  from  the  junction  of: 

Art.  plantaris  externa  with  art.  pedioea  (also  tibial.  postica  and  antica}. 
From  it  three  superior  and  five  anterior  branches  arise  : 

a.  Artt.  perforantes  (three)  ascend  (see  arc.  dorsalis}. 

b.  Artt.  interossea,  four,  pass  in  the  second  to  the  fourth  interstit.  in- 
teross.,  divide  at  the  anterior  extremity  into  two  branches : 

Artt.  digitales  plantares,  which  supply  the  outer  border  of  the  great, 
the  inner  of  the  fifth  toe,  and  both  plantar  borders  of  the  second, 
third,  and  fourth  toes,  and  unite  in  an  arch  on  the  ungual  phalanx. 

588.  The  Veins  of  the  great  Circulation. 

They  form,  with  the  exception  of  the  two  veins  of  the  heart,  two 
principal  trunks,  namely,  V.  cava  superior,  which  carries  the 
blood  from  the  superior,  and  V.  cava  inferior,  which  carries  it  from 
the  inferior  half  of  the  body  to  the  right  auricle  of  the  heart.  Both 
stand  in  relation  by  means  of  a  lateral  branch,  V.  azygos,  which 
arises  in  the  inferior  half  of  the  body  and  opens  into  the  superior 
vena  cava.  With  the  system  of  the  inferio'r  cava  an  important  one 
is  included,  the  system  of  the  Portal  vein,  and  in  the  foetus  the  um- 
bilical vein,  besides. 

589.  A.  Vence  cordis  s.  cardiacs. 

I.'V.  coronaria  magna  cordis.   Course :  from  the  apex  of  the  heart  as  far  as 


THE  VESSELS.  337 

basis  ventriculi  upwards  in  the  anterior  longitudinal  groove  ;  then  leaves  its 
art.  coron.  sinistra,  turns  in  the  left  transverse  groove  at  a  right  angle  to  the 
left,  and  opens  at  the  posterior  inferior  surface  into  the  right  auricle,  close  to 
the  septum  atriorum,  covered  by  valvul.  Thebesii.  Branches :  from  the  walls 
of  the  ventricles  and  the  septum;  it  receives  besides  : 

a.  F.  cordis  media  s.  Galeni  s.  posterior,  passes  in  the  posterior  longitudinal 
sulcus  from  the  apex  as  far  as  the  transverse,  and  opens  in  a  wide  place 
shortly  before  the  orifice  of  V.  magna. 

b.  V.  coronoria  dextra,  passes  from  the  left  border  of  the  heart  in  the  trans- 
verse  groove  to  the  right,  and  opens  shortly  before  the  orifice  of  F. 
magna. 

2.  Ft?,  minores  cordis,  3  to  4  small  veins  on  the  anterior  surface  of  the 
right  ventricle  of  the  heart,  open  into  the  right  auricle  ;  below  it  frequently 
v.  coro?iaria  dextra.  Vv.  and  foramina  Thebesii  do  not  exist  farther. 

590.  B.  Cava  superior  s.  descenders,  the  superior  or 

descending  cava, 

corresponds  to  the  arcus  aortce  and  the  aorta  thoracica  ;  arises  in 
consequence  of  the  association  of  anonyma  dextra  and  sinistra — 
close  behind  the  cartilage  of  the  second  right  rib,  one  inch  from  the 
middle  line  of  the  body.  Course  :  downwards  on  the  right  side  of 
the  sternum,  from  before  to  behind  and  from  left  to  right  to  the 
superior  part  of  the  right  auricle.  Position  :  the  superior  portion  ; 
on  the  inner  side  of  the  right  lung  (the  right  anterior  mediastina) 
and  the  JV.  phrenicus  dexter;  it  lies  to  the  left  on  the  art.  anonyma 
and  arcus  aortce,  behind  gland,  thymus,  before  (lymphatic  glands 
and)  trachea.  The  inferior  portion  inside  the  pericardium  (one  to 
one  inch  and  a  half  long),  close  before :  bronchus,  Art.  and  Ven. 
pulmonalis  (super.}  dextr. ;  touches  on  the  left  aorta  ascendens,  is 
free  to  the  right.  V.  cava  sup.  possesses  no  valves,  and  therefore 
pulsates.  Length :  three  inches.  Breadth,  at  the  mouth,  two 
inches.  Sometimes  two  Vv.  cc.  supp.  are  present.  Branches : 
V.  anonyma  dextra,  sinistra  and  V.  azygos. 

591.  1.  Vence  anonymcB  dextra  et  sinistra  [s.  Brachio- 

cephalica~\. 

They  correspond  on  the  one  side  to  truncus  anonymus,  on  the 
other  to  carotis  and  art.  subclavia.  Origin :  behind  the  articulatio 
sterno-clavicularis  and  from  the  junction  of  the  Ven.  jugularis  in- 
terna  and  subclavia.  Without  valves. 

22 


338 


SPECIAL  ANATOMY. 


Anonyma  dextra. 
Length:  twelve  to  fourteen 
lines.  Course:  vertically  down- 
wards and  inwards.  Pos. :  pa- 
rallel with  art.  anonyma,  which 
is  close  to  it  on  the  left ;  one 
inch  from  the  middle  line ;  to 
the  right  and  behind  TV.  phreni- 
cus  and  art.  mammar.  dextra. 
Branches :  Vv.  mammaria  in- 
ter na  and  thyreoid.  infer,  dex- 
tra ;  often  the  v.  vertebralis  alone. 


Anonyma  sinistra. 
Longer  (two  inches)  and 
thicker.  Course:  almost  horizon- 
tal, backwards  concave.  Pos. : 
above  arcus  aortce,  behind  the 
superior  border  of  the  Sternum, 
before  art.  anon.,  carot.,  and 
subclavia  sinistra.  Branches : 
Vv.  mammar.  interna,  thyreoi- 
dea  sinistra,  and  phrenica  su- 
per., thy  mica,  pericardiaca,  and 
often  v.  intercostalis  superior 
and  v.  vertebralis. 

The  collateral  branches  : 

1.  Vv,  tkyreoidecB  inferiores,  one  dextra,  one  sinistra.     Course  :  like  art. 
thyr.  infima;  the  former  opens  in  the  angle  between  the  two  Vv.  anony- 
mce,  the  latter  into  the  left  v.  anonyma;  they  receive  Vv.  tracheales  and 
laryng.  (plexus  trachealis). 

2.  Vv.  mammarice  internes,  two  for  each  artery ;  they  receive  Vv.  sternales 
(plexus  sternalis). 

3.  Vv.  phrenica,  very  long  and  small ;  they  pass  with  N.  phrenic,  and  art . 
phren.  super. 

4.  V.  vertebralis.     Origin:  in  the  deep  cervical  muscles,  and  a  smaller 
branch  from  the  foram.  condyloid.      Course :   in  the  canal,  vertebralis, 
passes  out  under  the  sixth  or  seventh  vertebra,  and  opens  close  behind  F. 

jugul.  intern.;  receives  V.  cervical,  ascend,  and  profund.     Position:  be- 
hind art.  subclavia. 

592.  1.  Jugularis  interna,  the  internal  jugular  vein,  corresponds  to  the 
carotis  communis  and  externa.  Or. :  in  the  foram.  jugulare  with  a  sacciform 
enlargement,  bulbus,  passing  out  of  the  sinus  transversus  of  the  cranial  cavity. 
Course :  descends  at  first  behind,  then  on  the  outer  side  of  carotis  interna, 
communis,  and  IV.  vagus  (which  lies  in  a  sheath  between  the  artery  and  vein 
behind  them),  and  terminates,  with  an  oval  enlargement,  bulbus,  at  the  origin 
of  truncus  anonymus  before  Art.  subclavia.  From  foram.  jugular,  to  the  su- 
perior border  of  the  larynx,  called  cephalica  interna,  two  inches  and  a  half  to 
three  inches  long ;  it  is  covered  by  m.  digastricus  and  sterno-mastoid,  on  the 
outer  side  of  the  nn.  glossophar.,  hypogloss.,  and  pharynx,  on  the  inner  of  the 
proc.  styloid.,  before  proc.  transvers.  of  the  first  to  the  third  vertebra.  At  the 
larynx  it  receives  the  short  cephalica  externa,  which  arises  from  the  junction  of 
facialis  anterior  and  posterior. 

a.  V.  facialis  anterior  corresponds  to  art.  maxillar.  externa.  Course  :  ex- 
ternal and  behind  art.  maxillar.  extern.,  downwards  and  outwards  from 
the  internal  angle  of  the  eye,  to  the  anterior  border  of  m.  masseler  over 


THE  VESSELS.  339 

the  lower  jaw  to  one  inch  beneath  its  angle.  Position  :  at  the  angle  of 
the  eye,  as  ven.  angvlaris,  before  the  lig.  palpebr.  intern.;  then  between 
levat.  labii  alaq.  nasi  and  orbicul.  palpebr.;  upon  levator  labii  super,  and 
buccinat.,  under  the  zygomatici  ;  beneath  the  lower  jaw  upon  gland,  sub' 
maxillaris.  Branches : 

1.  V.  frontalis,  between  the  skin  and  m.  frontalis,  near  the  central 
line  of  the  forehead,  to  the  root  of  the  nose. 

2.  V.  supraorbitalis,  between  m.  corrugator  and  frontalis,  from  without 
inwards,  anastomoses  with  vv.  temporales  ;  with  v.  frontalis  over  lig. 
palpebr.  intern.  ;  receives  v.  diploica  frontal. 

3.  V.  ophthalmica,  passes  backwards  from  the  v.  angularis  between  lig. 
palpebr.  int.  and  trochlea,  on  the  inner  wall  of  the  Orbita,  then  over 
IV.  opticus,  leaves  the  art.  ophthalm.,  and  passes,  at  the  internal  boun- 
dary ofjissur.  orbital,  super.,  into  the  sinus  cavernosus.     It  receives  : 
v.  sacci  lacrymal.,  ethmoidal.  anter.  and  poster.,  ciliar.  long,  and  vorti- 
COSGS,  lacrymalis,  central,  retinae  ;  lastly: 

v.  ophthalmica  inferior,  which  lies  on  the  floor  of  the  orbit,  formed 
of  vv.  muscular es  and  ciliares  inferior.,  likewise  anastomosing 
through  fissura  orbit,  infer,  with  ram.  prof  and.  v.  facial,  anter. 

4.  Vv.  nasales,  from  the  back  (dorsales)  and  alee  of  the  nose  (pinnales  s. 
alares.) 

5.  Vv.  palpebrales  inferiores  and  labiales  superiores. 

6.  Samus  profundus  s.  facialis  prof  undo  unites  the  v.  facial,  with  v. 
maxillar,  interna  and  ophthalmica  ;  arises  from  a  plexus  which  is 
formed  by  v.  ophthalm.  infer.,  nasalis  poster.,  dentalis  superior,  upon 
the  posterior  surface  of  the  upper  jaw,   is  connected   with  plex. 
pterygoid.,  and  opens  below  the  proc.  zygomatic.  of  the  upper  jaw. 

7.  Vv.  labiales    inferiores,    buccales,    massetericce,    submentalis,    sub- 
maxillar  es. 

8.  V.  palatina  arises  in  the  soft  palate  and  from  plex.  tonsillaris  ;  also 
open  into  cephalica  interna. 

b.  Vena  facialis  posterior.  Origin:  inside  the  parotis  behind  collumcon- 
dyli  max  ill.  infer.,  from  v.  temporalis  and  maxillaris  interna.  Position : 
on  the  inner  side  of  carotis  externa.  Course  :  behind  the  ram  us  of  the 
lower  jaw :  united  at  an  angle  with  V.  facialis  anter.  It  frequently 
opens,  as  it  passes  away  before  sterno-mastoideus  into  V.  jugularis  externa, 
and  sends  a  large  uniting  branch,  over  m.  digastricus,  to  V.  jugularis  in- 
terna. Branches : 

1.  V.  temporalis  communis  passes  backwards  from  art.  temporalis,  be- 
tween the  meatus  auditor,  externus  and  the  maxillary  articulation 
under  the  skin,  and  enters  the  parotis  ;  unites  behind  collum  con- 
dyli,  with  V.  maxillaris  interna  ;  consists  of: 

a.  Temporales  superficiales ;    these  are  branches  which  pass  from 
a  rete  with  wide  meshes  from  the  forehead,  vertex  and  occiput 


340  SPECIAL  ANATOMY. 

between  the  skin  and  muscular  layer,  unite  above  the  proc. 
zygomat.  of  the  temporal  bone,  and  unite  before  the  external 
auditory  meatus  with : 

b.  V.  temporalis  media;  passes  under  fascia  media;  over  m.  tern- 
poralis  from  before  backwards,  perforates  the  fascia  ;  consists  of: 
vv.  palpebral.  and  orbitales  externcs. 

2.  Maxillaris    interna    corresponds    to  the    inferior    portion  of  art' 
maxillar.  intern.  ;  receives  two  vv.  meningece  medics,  v.  dentalis  infe- 
rior, vv.  temporal.,  profundce,  pterygoidece,  masset ericas  ;  they  form 
plexus  pterygoideus  in  the  inferior  part  of  the   temporal  fossa,  be- 
tween m.  temporal,  and  pterygoid.  extern,  and  the  two  pterygoidei. 

3.  Vv.  parotidecs,  auricula  res  poster,  and  anter.,  transversa  faciei  form 
between  Parotis,  m.  masseter,  and  about  the  maxillary  articulation, 
the  large  plexus  massetericus,  which  is  connected  above  the  incisura 
semilunar.  with  pi.  pterygoid. 

c.  V.  occipitalis  passes  under  m.  splenius  forwards,  and  receives  several 
vv.  mastoidecB,  which  pass  out  of  sinus  transvers.  of  the  cranial  cavity, 
and  they  establish  an  important  communication  between  the  external  and 
internal  cranial  veins. 

d.  Ven.  thyreoidea  superior  ;  its  branches  come  from  the  superior  part  of 
the  thyroid   gland,  from  below  the  pharynx,  from  the  interior  of  the 
larynx  ;  it  opens  into  the  short  trunk  of  cephalica  externa  ;  likewise  the 
laryngea  and  lingualis  (s.  jugular,  externa}. 

e.  V.  thyreoidea  media  arises  from  art.  thyr.  infer.,  opens  into  the  trunk  of 
jugular,  interna. 

593.  Jugularis  externa  consists  of  an  anterior  and  posterior  (cutaneous) 
trunk,  which  open  together  behind  the  clavicle,  and  enter  into  the  V.  sub- 
clavia  or  V.  anonyma.  They  have  (two)  valves. 

1.  Jugularis  externa  anterior,  formed  by  one  or  two  vv.  subcutanecB  above 
the  hyoid  bone,  descends  along  the  inner  border  of  m.  sterno-cleido-mas- 
toideus,   and  curves  backwards  behind  the  inferior  termination  of  the 
muscle  to  the  posterior  trunk.     A  transverse  branch  unites  the  right  and 
left  vein,   and  generally   receives  the    V.  thyreoid.   media ;  a  superior 
transverse  branch  unites  both  in  the  region  of  the  os  hyoides. 

2.  Jugularis   externa  anterior.      Origin :  behind  the   angle   of  the   lower 
jaw,  from  a  branch  of  V.facialis  posterior,  V.  occipitalis,  and  auricular, 
superfic.     Course:   oblique  from  above  downwards,   and    from  before 
backwards,  over  the  sterno-cleido-mast.  ;  from  the  angle  of  the  lower  jaw 
as  far  as  the  centre  of  the  clavicle,  then  forwards  and  inwards  to  the 
v.subclavia.     Position:  superficial,  covered  by  M.  platysmam.  and  skin 
only;  above,  behind  it  N.  auricularis  ;  below,  behind  m.  sterno-cleido- 
mast.    Branches ;  besides  the  principal  rami : 

a  superior  connecting  branch  through  the  Parotis  with  V.  Jugularis 
interna  ; 


THE  VESSELS.  341 

an  inferior,  under  the  clavicle,   to    V.  cephalica  of  the  upper  arm ; 

farther : 

Vv.  transverse  colli  and  scapulas  ;  from  laryngea  superior,  and  often  ; 
V.  lingualis.  The  superficial  veins  upon  the  dorsum  lingua  (vv- 
linguales)  open  between  m.  lingualis  and  mucous  membrane  in  a 
plexus  lingual,  superior  at  the  basis  of  the  tongue.  From  it  a 
branch  accompanying  the  n.  li'igualis  passes  to 

Vv.  ranince.  They  pass  superficially  beneath  the  tongue  to  the 
side  of  the  frenulum,  accompany  N.  Jiypoglossus  between  TO. 
genio  and  hyo-glossus,  are  connected  with  plexus  inferior  at  the 
side  of  the  tongue,  and  open  in  the  Ven.  lingualis,  which  takes 
the  same  course  as  the  artery  (and,  frequently,  opens  into  cepha- 
lica externa). 

594.  3.  Vena  subdavia,  shorter  than  the  art.  subclavia.  Origin  :  at  the 
superior  border  of  m.  serratus  anticus,  from  v.  axillaris.  Termination  behind 
artic.  sterno-clavic.  Course:  transversely  inwards  to  the  orifice  of  V.jugu- 
laris  interna  (in  the  anonyma),  whilst  art.  subclav.  is  curved,  or  arches  over 
the  apex  of  the  lung.  Pos. :  behind  m.  subclavius  and  clavicle,  attached  by 
fascia  cervicalis  ;  before  art.  subclavia  (and  m.  scalenus  anticus  ;)  close  above 
the  first  rib,  beneath_/aseia  cervicalis  and  the  skin.  Valves-are  wanting. 

Branches :  V.  intercostalis  prima  dextra,  generally  V.  jugularis  externa  ; 
transversa  colli  and  scapula.  V.  subclavia  is  a  continuation  of: 

1.  Vena  axillaris,  which  is  placed  on  the  inner  and  anterior  side  of  atr. 
axillaris,  and  consists  of  the  two  vena;  brachiales  united  together,  which 
pass   deeply  on  both   sides  of   art.   brachialis.      Branches  :   circumflex, 
humeri,  subscapul.,  thorac.  extern.;  they  receive  the  V.  cephalica,  whilst 
the  rest  of  the  cutaneous  veins  open  into  vv.  brachiales.     The  deep  veins 
of  the  hand  and  the  fore-arm  correspond  exactly  with  the  distribution  of 
the  arteries  of  the  same  name,  but  are  double,  and  anastomose  together. 

2.  Cutaneous  veins  of  the  arm ;  they  are  larger  than  the  muscular  and 
deeply-seated  veins,  form  plexus,  and  are  situated  between  the  muscular 
layers  and  the  subcutaneous  uniting  tissue.     Strongest  on  the  dorsal  sur- 
face of  the  hand,  formed  by  the  ascending  digital  veins,  the  plexus,  con- 
cave above,  sends  off  several  branches  upon  the  carpus,  the  most  external 
of  which,  v.  cephalica  pollicis ,  passes  on  the  thumb  ;  the  most  internal,  r. 
salvatella,  on  os  metacarpi  V.     On  the  arm  the  cutaneous  veins  are  more 
numerous  on  the  flexor  surface.     They  are  : 

a.  Vena  cephalica  s.  cutanea  radialis,  the  continuation  of  cephalica  pol- 
licis, passes  along  the  outer  surface  of  radius  to  the  middle  of  it, 
about  the  external  border  upon  the  anterior  surface,  and  divides,  one 
to  two  inches  below  the  bend  of  the  arm,  into  the  mediana  and  cepha- 
lica brachii.  The  last  passes  at  first  on  the  outer  border  of  the  m. 
biceps,  then  inwards  to  the  groove  between  m.  pectoralis  maj.  and 
deltoid.,  where  it  opens  (one  inch  below  the  clavicle)  into  the  vena 


342  SPECIAL  ANATOMY. 

axillaris  ;  it  receives  the  cutaneous  veins  of  the  upper  arm,  shoulder, 
and  breast. 

b.  Vena  basilica  s.  cutanea  ulnaris,  a  continuation  of  salvatella,  passes 
on  the  ulnar  border  and  the  flexor  surface  of  the  fore-arm,  and  unites 
with  the  v.  mediana  (one  inch  to  two  inches  and  a  half)  above  the 
bend  of  the  arm.     When  an  ulnaris  posterior  is  present,  it  opens 
higher  up.     In  the  upper  arm  it  passes  on  the  inner  border  of  m.  bi- 
ceps, perforates  the  fascia  brachii,  and  opens  into  v.  brachialis  interna 
or  axillaris.    It  carries  the  blood  of  the  volar  side  of  the  hand  and 
of  the  fore-arm. 

c.  Vena  mediana  passes  obliquely  from  without  inwards,  and  from  be- 
low upwards,  from  v.  cephalica  to  v.  basilica,  larger  than  either,  lying 
in  the  bend  of  the  arm  over  the  aponeurosis  of  tendo  m.  bicipit.  and 
art.  brachialis.     It  carries  the  blood  of  the  dorsal  side  of  the  hand 
and  fore-arm,  and  also  receives  branches  from  the  volar  surface  and 
the  deep  veins  of  the  fore-arm.     Varieties  in  these  veins  are  parti- 
cularly frequent. 

595.  II.   Vena  azygos. 

This  vein  corresponds  with  the  aorta  thoracica,  uniting  v.  cava  in- 
ferior and  superior  with  one  another.  Or. :  in  the  abdominal 
cavity;  before  the  first  lumbar  vertebra,  rarely,  from  the  v.  rena- 
lis  or  v.  cava  inferior  itself.  Course  ;  through  hiatus  aorticus  into 
the  thorax  ;  on  the  right  side  of  the  thoracic  vertebra  as  high  as 
the  third  intercostal  space  ;  curving  over  bronchus  and  v.pulmonal. 
dextra  forwards,  it  opens  at  the  posterior  part  of  v.  cava  superior 
at  its  entrance  into  the  pericardium.  Situation  :  in  the  cavum 
mediastin.  posticum,  before  the  w.  intercostales  dextrce,  to  the 
right  of  aorta  and  ductus  thoracicus.  It  receives  in  front :  v.  bron- 
chialis  dextra,  some  vv.  cesophagece,  and  mediastina  ;  to  the  right 
the  eight  last  vv.  intercostales  dextrce  ;  to  the  left  v.  hemiazygos 
and  the  intercostales  superiores  sinistrce. 

1.  Vena  lumbalis  ascendens ,  the  connecting  ramus  of  the  transverse  vv.  lum- 
bales,  ascends,  curved  or  in  a  straight  line  ;  receives  a  branch  from  ven. 
iliaca  communis,  and  passes  into  the  v.  azygos  upon  the  right,  into  v. 
hemiazygos  upon  the  left  side. 

2.  Vena  hemiazygos.     Origin:  from  the  four  last  vv.  intercostales  sinistrce 
and  v.  renalis.     Course  :  through  hiatus  aorticus,  along  the  left  side  of 
the  vertebral  column  as  high  up  as  the  eighth  or  seventh  dorsal  vertebra, 
passing  before  them,  behind  ductus  thoracicus  and  aorta,  into  the  ven. 
azygos.     The  superior  (the  second  and  third)  vv.  intercostales  sinistrce 
generally  form  a  trunk  "(hemiazygos  superior},  which  opens  from  above 
downwards  into  hemiazygos  or  azygos,  accordingly  as  it  has  received  the 


THE  VESSELS.  343 

superior  ven.  bronchial,  sinistra.     It  receives  vv.  cesophagea,  mediastin. 
and  pericardiacecB. 

596.  C.  The  cava  inferior  s.  ascendens. 

Origin  :  before  the  cartilage  between  the  fourth  and  fifth  lumbar 
vertebra,  behind  and  to  the  right  of  the  bifurcation  of  aorta  abdo- 
minalis,  by  the  junction  of  the  two  vv.  iliacce.  Course :  vertical 
from  the  fourth  lumbar  to  the  ninth  dorsal  vertebra  ;  on  the  inferior 
surface  of  the  liver  curved  rather  forwards  and  to  the  right  towards 
the  posterior  portion  of  the  right  longitudinal  fossa,  it  passes  behind 
this  through  foram.  quadrilaterum  of  the  diaphragm,  immediately 
(half  an  inch  to  three  quarters  of  an  inch)  into  the  pericardium, 
and  there  horizontally  forwards  and  to  the  left  into  the  inferior 
posterior  part  of  atrium  dextrum. 

Situation:  to  the  right  on  the  anterior  surface  of  the  bodies  of  the  vertebra, 
to  the  right  of  the  aorta,  behind  the  peritonaeum,  the  inferior  horizontal  portion 
of  the  duodenum,  the  pancreas  ;  before  m.  psoas  and  the  right  cms  of  the 
diaphragm ;  above  in  a  semi-canal  of  the  liver.  Without  valves,  except  valv. 
Eustachii  at  its  mouth.  Collateral  branches  correspond  to  the  distribution  of 
the  branches  of  aorta  abdominalis,  with  the  exception  of  art.  ccdiaca  and  me- 
sentericee  (see  the  portal  vein) ;  they  are  : 

1.  Vv.  lumbales  and  lumbalis  ascendens. 

2.  Vv.  spermaticae.    a.  Testiculares  et  epididymece,  anastomosing  with  the 
vv.  pudenda  they  form  a  plexus  spermalicus  (s.  pampiniformis),  and  with 
vas  deferens  and  the  art.  spermatic,  the  spermatic  cord.    They  leave 
the  vas  deferens  on  its  entrance  into  the  pelvis,  and  pass  along  the  m. 
psoas  (with  art.  sperm.)  to  ven.  cava  inf.  [the  right]  and  v.  renalis  [the 
left] ;  the  left  behind  sigmoid  flexure  (therefore  frequently  varicose  [?]). 
b.   Ovaricte,  from  the  ovary,  uterus,  ligg.  rotund.  ;  they  form,  like  vv. 
testiculares ,  a  plexus  pampiniform.  at  the  orifice. 

3.  Vv.  renales,  the  right  is  shorter  and  passes  more  obliquely  upwards 
than  the  left,  which  receives  the  spermatica  sinistra,  and  passes  over  in 
front  of  the  aorta. 

4.  Vv.  suprarenales. 

5.  Umbilicalis  (see  §  559). 

6.  Vv.  phreniccs  inferiores,  two  for  each  art.  phrenica. 

7.  Vv.  hepaticcB,  arise  from  the  capillary  rete  formed  by  vena  portas  and 
art.  hepatica  in  the  lobules  of  the  liver,  open  with  eight  to  ten  small 
trunks  along  the  fossa  vena  caves,  with  two  to  three  larger  from  the 
right  and  left  lobes  of  the  liver  close  under  the  foramen  quadrilaterum, 
at  an  acute  angle  into  the  vena  cava.  They  pass  from  before  backwards 
(crossing  also  with  the  branches  of  v.  portce  and  art.  hepatica),  are  not 
placed  in  a  fibrous  sheath,  and  are  perforated  like  a  sieve  in  their  inte- 
rior by  the  minute  veins  opening  into  them. 


344  SPECIAL  ANATOMY. 

597.  I.   Vena  iliacce  communes. 

Origin  :  before  the  superior  part  of  symphys.  sacro-iliaca  by  the 
junction  of  vv.  iliacce  internet,  and  externa, — behind  the  division 
of  art.  iliaca  communis.  Termination  :  to  the  right  of  the  supe- 
rior border  of  the  fifth  lumbar  vertebra.  Course:  obliquely  up- 
wards and  inwards.  Valves  are  wanting. 

Iliaca  communis  dextra  \  Iliaca  communis  sinistra 
is  situated:  behind  and  to  the  is  situated:  internal  to  and  be- 
outside  of  art.  iliaca  comm.,  hind  its  artery  ;  at  the  mouth 
is  shorter,  and  receives  no  the  art.  iliaca  commun.  dextra 
branches.  It  is  not  compressed  descends  before  it  from  left  to 
by  an  artery,  like  the  left  com-  right;  receives:  V.  sacra  me- 
rnon  iliac  vein.  dia. 

1.  Iliaca  interna  s.  hypogastrica  corresponds  to  the  art.  hypogastrica,  and  its 
branches  (the  v.  umhilicalis,  only,  opens  into  v.  portcs).  Origin :  generally 
from  plexus,  on  the  walls  and  in  the  organs  of  the  pelvis,  and  in  the  external 
organs  of  generation.  Course  :  ascends  out  of  the  pelvis  before  m.  pyriformis 
and  symphys.  sacro-iliaca,  is  short.  Position :  behind  and  internal  to  the 
arteries  of  the  same  name.  They  and  their  branches  are  supplied  with 
veins. 

a.  Plexus  hcemorrhoidalis  surrounds  the  inferior  extremity  of  the  rectum, 
and  the  mucous  membrane  of  the  orifice  of  the  anus,  is  formed  by  Vv. 
hcemorrh.  super r.,  branches  of  v.  mesenterica  infer.,  and  the  vv.  hce- 
morrh.  mediae  and  infer.;  branches  of  v.  hypogastrica. 

b.  Plexus  vesicalis,  in  the  male  surrounds  Prostata  and  neck  of  the  blad- 
der, is  connected  with  a;  receives  the  vv.  superficiales  penis,  and  gives 
offtw.  vesicales.     In  the  female  it  is  smaller,  and  unites  with  plexus  va- 
ginalis. 

c.  V.  dor  salts  penis  arises  from  the  foreskin,  passes  (between  its  two  ar- 
teries) upon  the  back  of  the  penis,  connected  with  the  deep  veins,  and 
enters  under  the  pubic  angle  through  ligam.  pubo-prostaticumto  plex. 
prostaticus.     In  the  spongy  tissue  of  corpp.  cavernosa  arise  the  branches 
of  pudenda  interna. 

d.  Plexus  vaginalis  arises  in  the  erectile  tissue  of  the  introitus  vaginas, 
connected  with  plex.  vesicalis  and  hcemorrhoid. 

e.  Plexus  uterinus.     The  veins  of  the  uterus  form  large  trunks  not  tortu- 
ous, at  the  lateral  margins  (situs  uterini),  united  together  transversely, 
and  possessing  erectile  fibres,  like  the  tissue  of  the  Uterus;  they  unite 
with  the  vv.  ovaricce. 

f.  Vv.  iliolumbalis ,  sacra  lateralis,  obluratoria,  ischiadica,  pudenda,  glu- 
tcea. 

2.  Iliaca  externa  s.  cruralis,  takes  a  course  like  the  art.  cruralis.     In  the 


THE  VESSELS.  345 

pelvis  it  is  situated  on  the  inside  (and  behind)  in  the  femoral  ring :  on  the  inner 
side  (crural  hernia  passes  down  before  it) ;  below  the  mouth  of  v.  saphena: 
behind  ;  and  at  the  inferior  part  of  the  thigh :  on  the  outer  side  of  the  artery  ; 
in  the  popliteal  region  ;  behind,  and  rather  outside  the  art.  poplitcea.  In  the 
foot  and  leg  the  deep  veins  are  double  for  each  artery,  but  they  take  a  similar 
course.  The  v.  iliaca  externa,  only,  does  not  possess  valves. 
Cutaneous  veins  (with  very  thick  walls) : 

a.  Saphena  interna  s.  magna,  arises  from  plexus  dorsalis  pedis,  on  the  in- 
ternal border  of  the  foot,  passes  upon  the  dorsal  surface  of  os  metatarsi 
I.,  and  over  the  tarsus,  curves  from  below  upwards  before  the  inner 
malleolus,  then  ascends  on  the  internal  surface  to  the  posterior  border 
of  the  tibia  as  far  as  behind  condyl.  intern,  femor.  (on  the  inner  side  of 
the  tendons  of  mm.  semitendin.,  gracilis,  and  sartorius),  inclines  to  the 
front,  and  ascends  along  the  anterior  border  of  m.  sartorius  to  the  inner 
and  anterior  surface  of  the  thigh,  perforates  the  fasc.  cruralis,  and  sinks 
one  inch  below  the  femoral  arch  into  the  v.  femoralis.    It  receives  the 
cutaneous  veins  of  the  thigh,  of  the  anterior  abdominal  walls  and  Vt. 
pudend.  externce,  and  branches  of  the  deep  veins. 

b.  Saphena  externa  s.  parva  arises  from  plexus  dorsalis  pedis,  on  the  outer 
border  of  the  foot,  passes  round  behind  the  external  malleolus,  at  first 
on  the  outer  border  of  the  tendo  Achillis,  then  over  this  to  the  centre  of 
the  fibula,  and  thus  to  the  popliteal  region,  where  it  sinks,  between 
nerv.  tibialis  audfibularis,  close  to  t;.  articular  infer,  interna.  into  the 
popliteal  vein.   It  covers  and  crosses  the  n.  peronaus  twice.  It  receives 
branches  from  the  sole  of  the  foot  and  leg,  unites  with  v.  saphena  interna 
at  the  malleolus  and  back  of  the  foot ;  and  sometimes  also  opens  into 
it. 

598.      II.   Vena  portcz  s.portarum,  the  portal  vein, 

forms  a  tolerably  independent  system  of  vessels,  the  roots  of  which 
pass  forth  from  the  capillary  rete  of  the  organs  of  digestion,  unite 
into  one  venous  trunk,  which  again  ramifies,  in  a  dendritic  man- 
ner, like  an  artery,  in  the  liver,  so  that  its  blood  passes  along 
through  the  vv.  hepatica,  again  into  the  circulation.  It  corre- 
sponds to  Artt.  cceliaca,  mesenterica  superior  and  inferior,  with 
the  exception  of  art.  hepatica.  Origin  :  from  the  vv.  mesenterica 
superior  and  linealis,  united  at  an  acute  angle,  behind  the  head  of 
the  Pancreas,  the  duodenum,  in  the  centre  before  the  vertebral 
column,  to  the  left  of  the  Vena  cava  inferior.  Course  :  from  be- 
low upwards,  and  from  left  to  right,  four  inches  long,  to  the  left 
extremity  of  the  transverse  fossa  of  the  liver,  in  which  it  bifurcates. 
Situation  :  behind  cap.  pancreatis  and  pars  descend,  duodeni,  art. 
and  ductus  hepaticus,  before  v.  cava.  infer.  ;  within  the  capsula 
Glissonii,  between  the  two  layers  of  lig.  Jiepatico-duodenale. 


346  SPECIAL  ANATOMY. 

Branches  :  to  the  trunk  of  ven.  portce  also  pass  v.  gastrica  (sinis- 
tra)  superior  and  cystica  ;  from  the  trunk  passes  off  in  the  Porta 
(sinus  v.  portce)  : 

a.  Ramus  dexter,  the  shorter  and  thicker  branch  for  the  right 
lobe  of  the  liver. 

b.  Ramus  sinister,  for  the  left  and  the  two  central  lobes,  re- 
ceiving in  the  embryo  the  right  branch  of  the  umbilical  vein,  and 
gives  offductus  venosus  Arantii,  which  unites  v.  portce  and  v.  cava 
inferior. 

The  two  branches  pass  off  from  one  another  at  a  right  angle, 
quickly  divide,  continually  becoming  smaller,  and  form,  at  last, 
around  the  glandular  lobules  of  the  liver,  a  capillary  rete,  from 
which  the  vv.  hepaticce  come  off. 

1.  Lienalis  s.  splenica  arises  in  the  cells  of  the  spleen,  passes  through  the 
Hilus  and  transversely  to  the  superior  border  of  the  pancreas,  behind  and  be- 
low art.  lienalis,  towards  the  right  to  the  mesenterica  superior.  It  receives 
vv.  breves,  pancreaticce,  gastro-epiploica  sinistra,  and  : 

a.  V.  mesenterica  inferior.     This  arises  from  ven.  hemorrhoid.  superior  in 
the  plexus  hcBmorrhoidalis  of  the  rectum  (therefore  connected  with  v.  hy- 
pogastrica)  and  vv.  colicce  sinistrce;  passes  obliquely  to  the  right  and 
above  mesocolon  descendens,  before  the  vasa  renal,  and  behind  the  pan- 
creas to  the  splenic  vein,  near  to  its  confluence  with  v.  mesenterica  su- 
perior, in  which  it  even  often  opens. 

b.  Mesenterica  superior.     It  lies  on  the  right  and  anterior  side  of  the  ar- 
tery of  the  same  name,  arises  from  vv.  colica  dextra  and  intestinales, 
gastroepiplow.  dextra,  and  receives  in  the  embryo  the  v.  omphalo-mese- 
raica  from  the  umbilical  vesicle,  which  in  the  third  month  of  foetal  life, 
together  with  its  artery,  again  disappears. 

Anastomoses  of  the  portal  vein  :  1 .  between  the  vv.  hcemorrlioi- 
dal.  and  hcemorrhoid.  internet.  2.  Between  the  veins  of  colon 
transvers.,  descendens,  and  v.  cava  inferior. 

599.  Vena  umbilicalis,  the  umbilical  vein,  arises  in  the  embryo 
from  the  capillary  rete  formed  by  the  two  artt.  umbilicales  in  the 
Placenta.  Passing  through  the  umbilical  cord  and  ring  into  the 
belly  of  the  foetus,  it  advances  to  the  inferior  surface  of  the  liver 
(in  the  left  anterior  longitudinal  sulcus),  and  bifurcates  into  a 
larger  connecting  branch  for  the  left  branch  of  the  portal  vein,  and 
a  smaller  left  (duclus  venosus  Arantii),  which  carries  the  blood 
into  the  ven.  cava  inferior.  It  becomes  impervious  (in  one  month) 
after  birth,  and  then  passes  as  lig.  teres  hepatis.  It  is  larger  than 
the  portal  vein  of  the  foetus,  and  valveless.  Branches:  about 
twenty  small  ones  for  the  liver. 


THE  VESSELS.  347 

600.  The  Veins  of  the  vertebral  column, 

to  which  also  w.  azygos  and  hemiazygos  belong,  connect  together 
the  veins  of  all  parts  of  the  trunk,  so  that,  if  even  one  of  the  two 
cavoe  is  obstructed  in  any  place,  the  circulation  of  the  blood  is,  in 
consequence,  uninterrupted.  They  are  partly  external,  upon  the 
arches  of  the  vertebrae,  partly  internal,  in  the  canalis  spinalis, 
and  they  form  rete  in  the  whole  length  of  the  vertebral  column. 

1.  Internal: 

a.  Plexus 'spinales  interni  anteriores;  they  lie  close  upon  the  bones,  on  the 
posterior  surface  of  the  bodies  of  the  vertebrae  ;  they  appear  as  a  broad 
longitudinal  canal,  consisting  however  of  transverse  canals  lying  close 
together,  with  thin  walls,  connected  at  the  foram.  magnum  with  sinus 
occipital.;  they  receive  the  blood  from  the  vertebra?  and  the  dura  mater. 

b.  Plexus  spinales  interni  posteriores;  between  dura  mater  and  vertebral 
arches,  the   meshes  are   wider ;  they  form  a  ring  with  the  anterior 
plexus  between  two  vertebrae,  besides  two  canals  passing  close  to  the 
middle  line  ;  they  anastomose  with  the  : 

2.  External: 

a.  PL  spinales  externi  posteriores;  they  are  placed  with  wide  meshes  upon 
the  vertebral  arches  between  the  transverse  and  spinous  processes ; 
more  narrow  in  the  neck  (pi.  colli  poster.}  where  there  is  an  anasto- 
mosis with   sinus  transversus,   (through  foram.  condyloid.  post,   and 
mastoid.} 

b.  PI.  spinales  externi  anteriores;  do  not  exist  throughout  the  spine  ;  pi. 
colli  anter.,  pi.  sacralis. 

The  Lymphatic  vessels,  Vasa  lymphatica  s.  resorbentia. 

I.  The  Trunks. 

601.  Ductus  thoracicuS)  the  thoracic  duct, 

the  common  trunk  of  the  lymphatics  of  the  entire  inferior  and 
the  left  superior  half  of  the  body,  measures  transversely  in  width 
two  lines,  has  a  few  valves,  and  frequently  divides  into  two  or 
several  trunks,  which  again  unite. 

Origin  :  before  the  first  to  the  second  lumbar  vertebra,  to  the 
right  of  the  Aorta,  to  the  left  of  the  right  internal  cms  of  the 
diaphragm,  close  under  the  hiatus  aorticus  ;  by  the  confluence  of 
three  (to  six)  short  thick  ramuli,  the  central  one  of  which  com- 
prises the  lymphatics  of  the  organs  of  digestion  (chyliferous  ves- 
sels), whilst  the  lateral  consist  of  the  united  lymphatics  of  the 
inferior  extremities  and  the  pelvis.  One  or  two  of  the  united 
ramuli  is  enlarged,  one  to  two  inches,  before  the  commencement 


348  SPECIAL  ANATOMY. 

of  duct,  thoracic. ;  the  place  is  called  Ampulla  s.  cisterna  (ckyli) 
Pecqueti,  s.  receptaculum  chyli.  Course  :  tortuous,  before  and 
through  the  hiatus  aorticus  upwards,  rather  to  the  right  on  the 
anterior  surface  of  the  bodies  of  the  vertebra?,  to  the  right  of  aorta, 
to  the  left  of  the  v.  azygos.  Passing  almost  in  the  central  line  as 
far  as  to  the  front  of  the  fourth  dorsal  vertebra,  it  inclines  to  the 
left  behind  the  aorta,  on  the  left  side  of  (esophagus,  passes  out  on 
the  inner  and  posterior  side  of  art.  subclavia  sinistra  from  the 
thorax,  and  curves,  before  the  seventh  cervical  vertebra  and  behind 
the  v.  jugular,  intern,  sinistra,  in  an  arched  form  outwards  and 
forwards  to  the  angle  between  v.  jugularis  interna  and  subcla- 
via sinistra,  where,  provided  with  a  valve,  it  opens  singly  or  divided. 
Situation :  the  inferior  part  in  the  right,  the  superior  in  the  left 
mediastinum. 

602.  2.    Truncus  lymphaticus  dexter  s.  major,  the  right 

lymphatic  trunk, 

receives  the  lymphatics  of  the  right  half  of  the  head,  neck,  chest 
(the  right  lung,  the  right  heart,  and  half  of  the  liver  and  pharynx), 
and  the  right'  superior  extremity  ;  is  in  connexion  by  means  of 
branches  with  ductus  thoracicus.  It  arises  :  about  one  inch  above 
the  angle  of  vv.  jugularis  interna  and  subclavia  dextra,  in  which 
it  opens,  from  three  small  trunks,  in  which  the  lymphatics  of  the 
right  arm  from  without,  those  of  the  right  half  of  the  chest  from 
within,  those  of  the  head  and  neck  from  above,  flow  together. 
The  small  trunks  sometimes  open  into  the  veins  (subclavia  jugu- 
laris). 

603.  II.  The  Lymphatics  and  Lymphatic  glands  of  the  inferior 

half  of  the  body. 
I.  Inferior  extremity. — a.  Lymphatic  glands  : 

1.  Glandula  tibialis  antica,  lies  before  and  above  lig.  interosseum;  is  not 
always  present ;  is  formed  by  the  deep  lymphatics  of  the  foot. 

2.  Glandules  poplit&a,  two  to  four  small  glands  in  the  poplitasal  region 
along  the  vasa  poplitcea,  formed  by  the  deep  lymphatic  glands. 

3.  Gl.  inguinales  (seven  to  twenty),  surrounding  the  opening  of  the  v. 
saphena  magna,  and  are  situated  below  the  lig.  Pouparti,  in  the  fossa 
(fossa  ovalis)  between  m.  psoas  and  pectineus  on  the  thigh,  three  inches 
in  length,  two  in  breadth.     The  deep  (two,  three  to  seven)  are  some- 
times wanting,  they  are  situated  behind  \hefascia  cruralis  (round  about 
the  vasa  cruralia),  and  unite  through  the  opening  in  the  last  (where  the 
v.  saphena  perforates)  with  the  superficial,  which  lie  upon  the  v.  saphena 
andproc.  falciform.,  also,  immediately  with  the  gl.  iliaca  by  means  of 
the  femoral  ring. 


THE  VESSELS.  349 

b.  Lymphatics : 

1.  The  deep  accompany  the  deep-seated  blood-vessels  on  the  anterior  and 
posterior  surface  of  the  inferior  extremity.     The  anterior  pass  into  the 
gl.  tibial.  antica,  the  posterior  into  the  gl.  poplitoza,  and  thence  along 
the  v.  cruralis  into  the  gl.  inguinal,  prof. 

2.  The  superficial  arise  in  the  skin  of  the  foot,  the  posterior  partly  from 
the  sole,  corresponding  with  v.  saphena  parva;  the  anterior  come  off 
from  the  back  of  the  toes,  incline  inwards,  ascend  on  the  inner  side  of 
the  leg,  then  upon  Sartorius  to  the  superficial  inguinal  glands,  accom- 
panying the  F.  saphena  magna. 

2.  The  surface  of  the  external  parts  of  generation.      The  superficial  lym- 
phatics of  the  scrotum  and  penis  (or  the  inferior  portion  of  labia  majora),  be- 
take themselves  to  the  deep  and  most  superior  inguinal  glands,  also  those  of 
the  rectum;  they  correspond  to  the  vasa  pudenda  externa. 

3.  Anterior  inferior  abdominal  walls,  the  loins  and  buttocks. — Their  super- 
ficial lymphatics,  as  well  as  some  which  accompany  vv.  epigastric,  and  cir- 
cumflex, ilei,  pass  to  the  superficial  and  superior  inguinal  glands. 

4.  Internal  surface  of  the  pelvic  and  abdominal  walls  : 

a.  Lymphatic  glands : 

1.  Gl.  iliactB  externce  (six  to  eight),  along  the  vasa  iliaca  externa  and 
commun.  upwards  to  the  fifth  lumbar  vertebra ;  three  thereof  are  placed 
close  behind  the  femoral  ring  on  the  outer,  the  inner,  and  anterior  sur- 
face of  the  femoral  vessels. 

2.  Gl.  hypogastricas  (nine  to  twelve),  upon  and  close  to  vasa  hypogastrica, 
are  traversed  by  the  lymphatics  from  the  interior  of  the  organs  of  ge- 
neration (ras.  pudenda  internal. 

3.  Gl.  sacrales  (four  to  five),  laterally  before  the  promontorium  in  the  me- 
sorectum. 

4.  GL  lumbales  s.  aortica  (twenty  to  twenty-five),  on  the  sides  of  the 
aorta  (especially  this)  and  vena  cava,  upwards. 

b.  Lymphatics : 

1.  Plexus  iliacus   externus. — The  lymphatics  pass  out  of  the   inguinal 
glands,  through  fascia  cribriformis,  behind  the  v.  cruralis   into  the 
pelvis,  under  the  peritoneum  to  the  gl.  iliaca,  forming  a  plexus  about 
the  artery ;  on  the  other  side  to  the  gl.  hypogastricce,  where  they  form 

2.  Plexus  hypogastricus,  about  art.  hypogastrica,  and  also 

3.  Plexus  sacralis  on  the  posterior  pelvic  wall,  passing  into  the 

4.  Plexus  lumbalis  (and  gl.  lumbalis).      This  plexus  extends  around  the 
aorta  abdominal,  and  v.  cava  inferior,  receives  the  lymphatics  of  the 
kidneys,  testicles,  and  spermatic  cords,  and  the  female  internal  organs 
of  generation,  and  forms  the  lateral  roots  of  the  ductus  thoracicus. 

5.  Of  the  urinary  organs  : 

1.  Lymphatics  of  the  kidneys  and  supra-renal  capsules,  are  superficial 
and  deep.  The  last  pass  forth  at  the  hilus  of  the  kidney,  form  plexuses, 


350  SPECIAL  ANATOMY. 

and  open  into  the  plexus  lumbalis,  after  they  have  united  with  those  of 
the  supra-renal  capsules,  and  received  those  of  the  ureters. 
2.  Lymphatics  of  the  urinary  bladder  open  into  plexus  hypogastricus. 
6.  Organs  of  generation  : 

1.  Lymphatics  of  the  testicle  pass  in  the  spermatic  cord,  and  in  the  sper- 
matic vessels,  forming  a  plexus  spermaticus  to  the  plex.  lumbalis. 

2.  Lymph,  of  corpora  cavernosa  pass  with  the  art.  pudenda  under  the 
symphysis  pubis  to  the  plex.  hypogastricus,  to  which  also  those  of  the 
seminal  vesicles  and  preputial  glands  proceed. 

3.  Lymph,  of  female  internal  organs  of  generation.     Those  of  the  collum 
uteri  pass  to  the  plexus  hypogastricus  and  plexus  sacralis;  the  remain- 
ing lymphatics  of  the  uterus  to  the  superior  angles  of  the  last,  and 
thence,  united  with  those  of  the  tubes,  the  ovaria,  and  ligg.  lata,  with 
the  vasa  spermatica  to  plex.  lumbalis. 

604.    III.  The  Lacteals  [lymphatics]  and  Lymphatic  Glands 
of  the  organs  of  digestion. 

1.  Small  intestines. — a.  Lymphatic  glands. 

Gland,  mesentericce,  130  to  150,  and  situated  in  rows  between  the  laminae 
of  the  mesenterium,  the  largest  at  the  origin,  and  at  the  extremity  of 
vasa  mesaraica  superiora.  The  former,  are  gl.  duodenales,  they  lie  be- 
fore the  duodenum;  the  latter  are  gl.  ileo-colica,  in  the  angle  between 
ileum  and  colon.  (They  readily  inflame.) 

b.  The  lymphatics  are  particularly  numerous  in  the  so-called  Jejunum. 
The  superficial  arise  from  the  serous  and  muscular  coats ;  the  deep,  vasa  lac- 
tea,  which,  during  the  process  of  digestion  carry  white  chyle  from  the  villi  of 
the  mucous  membrane,  and  pass  from  gland  to  gland  around  the  truncus  cce- 
liacus,  to  form  the  middle  root  of  the  ductus  thoracicus. 

2.  Of  the  large  intestines,     a.  Lymphatic  glands. 

Gland,  mesocolicce,  twenty  to  fifty,  are  placed  connected  with  the  gl.  mesen- 
tericcB.  They  are  most  numerous  in  the  mesocolon  transversum,  along  the 
vascular  arches  of  art.  and  vv.  colicce. 

b.  Lymphatics.  Those  of  the  ccecum,  colon  ascendens,  and  transversum, 
pass  through  gl.  mesocolic.  to  the  gl.  mesenterica  ;  those  of  the  colon  descen- 
dens  and  rectum  to  the  gl.  lumbales  and  sacrales. 

3.  Of  the  stomach,    a.  Lymphatic  glands. 

1.  Gl.  gastro-epiploiccB  superiores  (four  to  six)  are  situated  in  the  small 
omentum  on  the  small  curvature  along  the  art.  coronar.  ventric.  sinis- 
tra. 

2.  GL  gastro-epiploicce  inferiores  (six  to  eight)  in  the  great  omentum  on  the 
great  curvature,  along  the  art.  coron.  ventric.  dextra.    They  are  espe- 
cially accumulated  about  the  ostia  pyloricum  and  cardies,  and  they  send 
their  vasa  efferentia  to  the  gland,  coiliacce. 

b.  Lymphatics.  The  superficial  form  a  plexus  beneath  the  peritoneal  in- 
vestment; the  deep,  likewise,  upon  the  mucous  membrane,  and  they  incline, 


THE  VESSELS.  351 

partly,  to  the  great,  partly  to  the  lesser  curvature,  to  the  gl.  lienales  and  gl. 
pylorica. 

4.  Spleen  and  Pancreas,    a.  Lymphatic  glands. 

1.  Gl.  lienales  are  placed  in  the  hilus  of  the  spleen. 

2.  Gl.  pancreatico3,  at  the  superior  border  of  the  pancreas  along  the  art. 
splenica. 

b.  Lymphatics.  Those  of  the  spleen  are  said  to  carry  a  red  lymph  (Hew- 
son) ;  the  superficial  come  from  the  covering,  the  deep  from  the  Parenchyma; 
they  form  a  plexus  in  the  hilus,  and  pass,  with  the  lymphatics  of  the  pancreas, 
along  the  art .  lienalis  to  the  gl.  cceliaca. 

5.  Of  the  liver,    a.  Lymphatic  glands. 

1.  Gl.  hepaticcB,  small  glands,  in  the  porta,  they  pass  into  the 

2.  Gl.  cceliaccs  (sixteen  to  twenty),  which  are  placed  round  about  the  tripus 
Halleri,  receive  the  lymphatics  of  the  superior  organs  of  digestion,  and 
assist  in  forming  the  lateral  roots  of  the  ductus  thoracicus. 

b.  Lymphatics.  Those  upon  the  superior  surface  of  the  liver  pass  partly 
forwards  through  the  diaphragm  behind  the  proc.  ensiformis  to  the  gl.  medi- 
astinae  anticte  (others  to  the  smaller  curvature  of  the  stomach),  partly  from 
before  to  the  posterior  border ;  on  the  inferior  surface  of  the  liver  they  pass 
from  before,  backwards :  those  which  pass  to  the  right  of  the  gall-bladder,  to 
the  gl.  lumbales  ;  those  which  lie  to  the  left,  to  the  gland,  cardiacce  ;  those 
which  surround  the  gall-bladder  in  a  plexus,  to  the  gl.  hepaticce  and  c&liactB. 
The  deep  lymphatics  pass  out  on  the  ductus  hepaticus,  and  the  Ven.  portoz  in- 
side the  capsula  Glissonii,  and  proceed  to  the  same  glands. 

605.     IV.  Lymphatics  and  Lymphatic  glands  of  the  superior 
half  of  the  body. 

1.  Of  the  superior  extremity,    a.  Lymphatic  glands. 

1.  Gl.  cubitales,  two  to  three  superficial  in  the  bend  of  the  elbow,  three  to 
four  deep  at  the  same  place  above  condyl.  internus,  behind  v.  basilica. 

2.  Gl.  brachiales,  five  to  seven  small  glands  along  the  art.  brachialis. 

3.  Gl.  axillares,  ten  to  twelve  in  the  axilla,  and  round  about  art.  axillar,, 
connected  by  means  of  a  plexus  axillaris  ;  they  receive  the  lymphatics  of 
the  superior  extremities  and  thoracic  parietes,  and  pass  with  four  to  five 
vasa  efferentia  into  the  plexus  subclavius,  and  thence  into  the  truncus 
communis.  ; 

b.  Lymphatics.  The  superficial  pass  with  vv.  cephalica  and  basilica,  the 
deep  with  the  arteries  ;  both  terminate  in  the  gl.  axillaris. 

2.  Of  the  external  walls  of  the  thorax. — The  lymphatics  of  the  anterior 
and  lateral  parietes  ascend  over  m,  pectoralis  and  serratus  major  to  the 
gl.  axillares  ;  those  of  the  posterior  walls  upwards  and  downwards  (under 
the  tendon  of  m.  longis.  dor  si),  to  the  same. 

3.  Of  the  internal  thoracic  parietes.    a.  Lymphatic  glands. 

1.  Gl.  intercostales  (sixteen  to  twenty);  they  are  small,  and  lie  close  to  the 
dorsal  vertebra  on  the  anterior  surface  of  the  heads  of  the  ribs ;  some 


352  SPECIAL  ANATOMY. 

between  the  mm.  intercostales  ;  they  send  their  vasa  efferentia  into  ductus 
thoracicus  and 

2.  Gl.  mediastincB  posteriores  (eight  to  twelve).     They  are  placed  along  the 
aorta  thoracica  and  oesophagus,  receiving  the  lymphatics  of  the  (esophagus 
and  pericardium. 

3.  Substernales,  they  pass  along  the  art.  mammaria  interna,  one  in  each  in- 
tercostal space,  close  to  the  sternum. 

4.  Gl.  mediastincB  anterior es  are  placed,  partly  (three  to  four)  upon  the  dia- 
phragm before  the  pericardium,  partly  (eight  to  ten)  round  about  the  arcus 
aort.,  ven.  cava  superior  and  innominata  at  the  basis  cordis.     Their  vasa 
afferent,  come  from  the  convex  surface  of  the  liver,  the  diaphragm,  peri- 
cardium, the  thymus. 

b.  Lymphatics : 

1.  Plexus  intercostales  consists  of  the  deep  lymphatics  along  the  artt.  and 
vv.  intercostales,  receive  the  lymphatics  of  the  vertebral  columns,  pass 
through  gl.  iidercostales  and  mediastin.  poster.,  and  into  the  duct,  thora- 
cicus.    They  have  roots  in  the  mm.  Intercast,  and  pleura  costalis. 

2.  PL  mammarius  internus.     The  lymphatics  of  the  superior  half  of  the  an- 
terior abdominal  walls  ascend  behind  proc.  ensiform.,  united  with  those 
on  the  external  surface,  by  means  of  the  gl.  substernales  as  high  upwards 
as  the  gl.  cervicales  inferiores,  and  into  the  ductus  thoracicus  and  truncus 
lymph,  dexter. 

3.  The  lymphatics  of  the  diaphragm  pass  to  the  pi.  Intercast,  and  hepatic. 
and  to  the  gl.  substernales. 

4.  Of  the  Thoracic  viscera:  a.  The  lymphatic  glands.     Glandules  bronchi- 
ales  s.  Vesaliance  (twenty  to  thirty,  larger)  are  situated  along  the  bronchi 
and  their  point  of  bifurcation,  the  largest  usually  at  the  division  of  trachea, 
the  smallest  (gl.  pulmonares)  penetrate  the  substance  of  the  lungs.     In 
youth  yellowish  white,  they  become  in  time  (from  the  tenth  year  onwards) 
darker,  blue  and  black,  and  readily  ossify. 

b.  Lymphatics  of  the  lungs.     The  superficial  form  beneath  the  pleura  a 
close  rete  and  pass,  generally  inwards  to  the  gl.  bronchioles  at  the  roots  of  the 
lungs.     The  deep  arise  from  the  lobes  of  the  lungs  and  pass  to  gl.  bronchial. 
and  gl.  ossophagecB.     Vasa  efferentia  of  the  bronchial  glands  pass  to  gl.  trachea- 
les  and  cesophag.  and  with  these  into  the  ductus  thoracicus  and  trunc.  lymphatic, 
dexter.;  several  also  into  v.  jugularis  interna. 

c.  Lymphatics  of  the  heart.     The  superficial,  beneath  the  membr.  serosa, 
generally  pass  on  the  right  border ;  the  deep  arise  from  the  internal  membrane 
of  the  heart ;  they  pass  with  the  last  from  the  pericardium,  and  sink  into  the 
pi.  aorticus  before  aorta  and  art.  pulmon.,  and  into  the  ductus  thoracicus.     The 
lymphatics  of  the  thymus  gland  and  pericardium  pass  into  the  gl.  substernales, 
mediastin.  anteriores  and  bronchioles. 

5.  Of  the  head  and  neck.     a.  lymphatic  glands  of  the  head. 
1.  Glandulce  subauriculares,  under  and  behind  the  auricle,  behind  the  in- 
sertion of  m.  sterno-cleido-mostoid.;  they  are,  like  the  rest  (gl.  mastoidece, 


THE  VESSELS.  353 

occipitales)  of  the  lymphatic  glands  of  the  skull  (which  are  only  found  on 
the  back  of  the  head)  very  small  and  less  numerous. 

2.  Gl.  submaxillares,  the  largest  in  the  face,  they  lie  at  the  basis  mandibula 
(eight  to  ten)  and  along  the  art.  maxillaris;  they  open  into  gl.  cervicales 
superficiales. 

3.  Glandules  parotidea,  deep,  lying  superficially  between  parotis  and  m. 
masseter. 

4.  GL  zygomaticcB,  under  the  zygoma,  they  open  into  gl.  submaxillares  and 
cervical,  superf. 

5.  Gl.faciales  profunda,  behind  m.  buccinator,  and  on  art.  maxillar.  intema, 
they  receive  the  deep  lymphatics  of  the  face ;  its  cavities  and  the  dura 
mater;  they  open  into  gl.  cervical,  profunda. 

b.  Lymphatics  of  the  head.     The  superficial  accompany  the  art.  temporal, 
superf.  to  the  gl.  parotid.,  and  the  art.  occipitalis  to  gl.  mastoidece.     The  deep 
rasa  lymphatica  meningea  pass  on  the  art.  and  v.  meningea  med.  to  the  gl.  ju- 
gulares.     No  one  has,  at  present,  been  able  to  follow  lymphatics  into  the  sub- 
stance of  the  brain.     The  superficial  lymphatics  of  the  face  pass  along  the 
blood-vessels  to  the  gl.  submaxillares;  the  deep  pass  out  from  the  temporal,  and 
pterygo-palatine  fossae  and  the  nasal  cavities.     Those  of  the  tongue,  pharynx, 
velum  palati  and  larynx,  open  into  the  gl.faciales  prof,  and  gl.  cervicales. 

c.  The  lymphatic  glands  of  the  neck  are  placed  upon  its  anterior  surface. 

1.  Gl.  cervicales  superficiales  are  situated  generally  along  the  F.  jugular, 
externa,  in  the  triangular  space  between  clavicula,  mm.  sterno-cleido- 
mastoid.  and  trapezius,  covered  by  plat ysmamy aides;  also  several  small 
ones  under  the  os  hyoides. 

2.  Gl.  cervicales  profundce  pass  in  numbers  along  the  V.  jugular,  and  carotis 
intern.,  from  the  process,  mastoid.,  as  far  downwards  as  the  superior  open- 
ing of  the  cavity  of  the  thorax,  before  the  vertebral  column  on  the  sides 
of  the  pharynx  and  oesophagus,  and  are  connected  with  gl.  tracheales. 

d.  The  lymphatics  of  the  neck  come  from  the  pharynx,  ossophagus,  larynx, 
trachea,  pass  through  the  gl.  cervicales,  and  out  of  these  into  a  common  trunk, 
which  empties  itself  upon  the  left  side  into  the  ductus  thoracicus,  upon  the 
right  into  the  truncus  lymphaticus  dexter. 


23 


OF  THE  NERVES, 

NEUROLOGIA. 


"  The  knowledge,  then,  of  what  is  termed  the  Economy  of  an  Animal 
Body  is  to  be  acquired  only  by  an  intimate  acquaintance  with  the  distri- 
bution and  uses  of  the  nerves  ;  and  this  knowledge  of  the  natural  relations 
leads  directly  to  the  comprehension  of  the  signs  of  disturbed  function,  or  the 
symptoms  of  disease." — Sir  C.  BELL.  The  Nervous  System  of  the  Human 
Body.  Preface,  3d  edition. 

"  At  first  this  intricate  network  seems  accidental ;  neither  arrangement 
nor  system  is  apparent ;  but  when  the  minute  twig  discovered  by  one  anato- 
mist in  London  is  as  surely  found  by  another  at  Pavia,  as  two  astronomers, 
at  different  spots  on  the  globe,  trace  in  the  heavens,  with  the  same  certainty, 
the  discoveries  of  Herschel,  there  can  no  longer  be  a  doubt  of  the  nerves 
being  distributed  with  regularity  and  system. 

"  There  is  no  such  thing  as  a  nerve  deviating  or  being  wanting  (an  occur- 
rence frequent  in  the  vascular  system),  without  the  loss  of  some  essential 
faculty."  Introduction. 


NEUROLOGY. 

LITERATURE  : 

Bell,  Sir  C.    Nervous  System  of  the  Human  Body,  3d  edit.   1844,  and 

Papers  in  Phil.  Trans.  1821,  and  after. 
Art.  "  Nervous  Centres."     Cycl.  of  Anat.  and  Phys. 

"  Ganglion."     Idem. 

Solly.    Anat.  and  Phys.  of  the  Human  Brain.     New  edition. 

Clark,  Le  Gros.     Practical  Anat.  and  Elementary  Phys.  of  the  Nervous 

System.     1836. 
Animal  Electricity.    Art.  Cycl.  of  Anat.  and  Phys. 

Luminousness.     Idem. 

Burrowes.    Cerebral  Circulation.     Lumleian   Lect.   1843,   Med.   Gaz.   vol. 

xxxii. 

Mayo's  Anat.  and  Phys.  Commentar.    EeiVs  Essays. 
Longet.     (In  French.)    Anat.  et  Phys.  du  Systeme  Nerveux. 
Hatt's,  Marshall,  Works.     On  the  Nervous  System.     1843. 
Reid.    Edin.  Med.  and  Surg.  Journal,  vol.  xlix.  and  li. 
Swan.    A  Demonstration  of  the  Nerves  of  the  Human  Body. 
Burrowes.    Med.  Gaz.  vol.  xvi. 
T.   W.  King.    The  Course  of  the  Motor  Cords ;   also  on  Reflex  Action. 

Med.  Times,  Nov.  1844. 
E.  Cock.     Obs.  on  the  Gangl.  Enlargement  of  the  Pneumo-gastric  Nerves. 

Guy's  Hosp.  Rep.  vol.  ii.  p.  311. 
J.Hilton.    Distribution,  &c.  of  the  Laryngeal  Nerves.     Guy's  Hosp.  Rep. 

vol.  ii.  p.  514. 


357 


THE  NERVES,  NEUROLOGIA. 

606.  The  nervous  system,  sy sterna  nervosum,  the  organ  of 
psychical  life,  of  sensation,  and  (in  reciprocal  action  with  the  mus- 
cular tissue)  also  that  of  motion,  consists  of  two  principal  portions, 
the  central  and  peripheral,  both  of  which  are  uninterruptedly  united 
together,  and  are  not  even  different  in  substance.     The  central  ner- 
vous mass  is  compressed  into  the  cranium  and  medullary  canal  of 
the  spine ;  the  peripheral  penetrates  (as  nerves)  the  organs  of  the 
body,  and  spreads  itself  out  like  the  branches  of  a  tree  from  the 
central  portion. 

607.  1.   The  tissue  of  the  Nervous  system. 

It  consists  of  two  portions,  opposed  to  one  another,  which  are 
found  in  the  nerves  as  well  as  in  the  central  portions ;  these  are  : 

608.  a.    The  primitive  fibres.     They  are  cylindrical,  isolated  in 
their  whole  course,  undivided,  with  soft,  peculiar  contents,  and  sur- 
rounded by  a   delicate  envelope.     In  the  nerves  we  observe  an 
external  sheath,  consisting  of  fibres  of  uniting  tissue,  which,  taking 
a  longitudinal  direction,  are  connected  with  the  envelope  of  the  whole 
nerve,  and  an  internal  delicate  limiting  membrane,  which  appears 
to  consist  of  fibres  arranged  spirally,  and  closely  surrounds  the 
nervous  contents  (neurine)  of  the  primitive  fibre.     Both  sheaths 
become  transparent  by  means  of  dilute  acetic  acid.     The  neurine 
is  (in  the  fresh  state)  homogeneous,  milk-white,  soft,  readily  coagu- 
lated by  cold,  alcohol,  common  salt,  &c.,  and  then  presents  in  the 
middle  a  central  stripe  (cylinder  axis  Purkinje),  which  is  not  yet 
coagulated.     In  consequence  of  yielding  or  laceration,  whilst  ma- 
cerating in  water,  the  primitive  fibres  appear  knotty  (varicose). 
In  the  central  parts,  the  primitive  fibres  are  more  delicate,  and  are 
not  surrounded  by  an  external  sheath ;  but  they  are,  otherwise,  in 
the  same  condition  as  in  the  nerves.     They  form  the  white  sub- 
stance of  the  former. 

609.  b.  Ganglion  globules  (globuli  gangliorum),  the  nucleated 
bodies  of  the  nerves,  form  kidney-shaped,  three  or  four-cornered 
cells,  in  which  is  found  a  clear  vesicular  nucleus,  and  within  this  a 
nucleolus.     The  contents  of  the  cell  are  soft,  granular,  brownish 
yellow,  or  gray.     The  nucleolus  yellowish  brown,  solid.     They 
are  probably  surrounded  by  an  internal  sheath,  but  fixed  by  an 
external  (often  reddish)  fibrous  capsule.    They  are  placed  in  masses 


358  SPECIAL  ANATOMY. 

between  and  round  about  the  primitive  nervous  fibres.  Their  ex- 
ternal vaginal  processes  give  a  weak,  gray  appearance  (especially 
to  the  n.  sympathicus),  misled  by  which  they  have  been  regarded 
as  vegetative,  organic,  nervous  fibres,  since  they  stand  in  relation 
with  forms  of  uniting  tissue,  only  (Valentin). 

The  ganglion  globules  of  the  central  portions  are  extremely  deli- 
cate and  difficult  to  isolate ;  the  vaginal  formation  is  here,  also, 
doubtful.  They  form  the  gray,  yellow,  and  brown  substance  of 
the  brain  and  spinal  marrow. 

The  white  or  medullary  substance  is  formed  of  primitive  fibres. 
The  gray  or  cortical  substance  of  ganglion  globules ;  it  is  more 
plentifully  supplied  with  vessels  than  the  white. 

610.  2.   The  chemical  elements. 

The  medullary  substance  of  the  brain  consists  of  four-fifths  water ; 
Cholesterine ;  Cerebric  acid,  free,  or  united  with  soda  or  phosphate 
of  lime;  Oleophosphoric  acid,  free,  and  with  soda;  Oleineand  Mar- 
garine; Oleic  and  Margaric  acids;  Albumen,  with  sulphur  (Fremy). 
Moreover,  the  sheaths  of  the  nerves,  with  vessels  and  uniting  tissue, 
are  to  be  attended  to  in  the  examination.  The  medullary  substance 
contains  more  fat,  the  cortical  substance  more  albumen,  the  spinal 
marrow  more  fat  and  less  albumen,  the  nerves  more  albumen  than 
the  brain.  (Vauquelin). 

611.  The  peripheral  portion  of  tfo  Nervous  system, 

nerves,  nervi,  are  long  portions  formed  of  bundles  (fasciculi),  lying 
close  together,  and  cords  (funiculi)  of  primitive  fibres,  which  place 
the  surfaces  of  the  body  and  muscles  in  connexion  with  the  central 
portions,  and  are,  partly,  the  conductors  of  sensations  from  the 
periphery  to  the  centre  ;  partly,  the  conductors  of  movements  from 
the  latter  to  the  former.  There  are  two  kinds,  white  and  gray : 

The  white  nerves  (animal  or  cerebro-spinal)  are  strong,  bright, 
transversely  striped,  spread  out  in  the  muscles  of  the  trunk  and  in 
the  skin,  and  are  surrounded  by  a  sheath  of  strong,  fibrous,  uniting 
tissue,  the  Neurilemma,  which  blends,  externally,  with  the  amor- 
phous uniting  tissue  of  the  surrounding  parts ;  internally,  in  the 
outer  sheath  of  the  delicate  nervous  fasciculi  (see  before).  The 
primitive  fibres  of  the  white  nerves  (diam.  0*080 — 0*084  of  a  line) 
are  strongest  in  the  muscles  of  voluntary  motion,  and  most  delicate 
in  the  nerves  of  the  senses. 

The  gray  nerves  (vegetative)  are  soft  (see  nervi  molles),  but 
tolerably  strong,  diaphanous,  reddish  gray,  not  transversely  striped ; 
their  neurilemma  very  strong,  and  provided  with  an  annular  layer. 


THE  NERVES.  359 

They  form  a  plexus  about  the  vessels  (which  serve  for  their  sup- 
port), and  proceed  to  the  involuntary  muscles  (see  n.  sympathicus). 
The  more  primitive  fibres  there  are  found  in  them,  the  more  they 
resemble  the  white  nerves,  e.  g.  the  nerves  of  the  heart. 

1.  Course.  Every  primitive  fibre  passes  uninterruptedly,  and 
without  branches,  from  the  central  to  the  peripheral  extremity, 
generally  outwards  and  downwards.     The  nerves  mostly  enter  the 
organs  from  within;  or  rather,  they  pass  to  their  actually  free 
surface. 

2.  Combinations  take  place  in  this  way,  only  that  fasciculi  pass 
over  from  one  nervous  trunk  into  another,  the  primitive  fibres 
always  passing  in  an  isolated  condition,'  never  coalescing  with  one 
another.     The  different  kinds  of  combination  are  as  follows  : 

a.  Anastomosis,  loops. — A  part  of  the  fasciculus  of  a  trunk  is 
detached,  and  passes  away  as  a  distinct  branch  (ramus).     It 
goes  into  the  sheath  of  another  trunk,  and  applies  itself  to 
this,  thus  forming  a  simple  anastomosis.     When  an  inter- 
change of  fasciculi  takes  place  between  two  trunks,  a  re- 
ciprocal and  decussating  anastomosis  arises. 

b.  An  interlacement,  plexus,  signifies  the  combination  of  anasto- 
mosing branches  into  a  network,  the  meshes  of  which  are 
empty,  or  are  filled  by  other  tissues.     From  each  root  of  the 
plexus  each  of  the  nerves  passing  off  from  it  contains,  at  last, 
separate  fasciculi.     Plexus  gangliosus  signifies  a  plexus,  the 
meshes  of  which  are  filled  up  with  ganglion  globules. 

c.  Nervous  ganglia,  ganglion  nervosum,  is  a  smaller  or  larger 
intumescence,   formed   by   the   accumulation    of   peripheral 
ganglion  globules.     In  addition  to  these,  their  sheaths  and 
vaginal   processes,  a  larger  or  smaller  number  of  primitive 
fibres  are  found   in  it  which  pass    through  the    ganglion, 
singly,  or  forming  a  plexus,  and  entwining  about  the  glo- 
bules.    The  ganglion  is  surrounded  by  a  strong  neurilemma, 
in  which  the  capillary  vessels  ramify. 

612.  3.  Origin  and  terminations.  The  roots  of  the  nerves 
are  the  immediate  continuations  of  the  primitive  fibres  of  the  brain 
and  spinal  cord.  The  posterior  roots  contain  finer,  the  anterior 
coarser,  fibres.  United  into  fasciculi  and  trunks,  they  divide,  as 
before  described,  and,  finally,  spread  out  in  the  substance  of  the 
organs  in  loops,  so  that  the  primitive  fibre  is  reflected  at  its  ex- 
tremity and  returns  to  the  centrum,  no  proper  termination  to  it 
being  present. 

The  plexus,  in  which  the  terminations  of  the  nerves  resolve 


360  SPECIAL  ANATOMY. 

themselves,  are,  like  the  capillaries,  variable,  according  to  the 
organs  into  which  they  enter. 

In  the  contractile  tissues  (muscles,  and  so  forth),  the  nerves  are 
said  (by  C.  Burdach)  to  terminate  with  narrow  loops,  in  the  parts 
endowed  with  sensation  (the  skin,  organs  of  the  senses,  &c.),  with 
plexuses  and  wide  loops. 

Moreover,  each  single  muscular  fibre  and  cell  of  an  organ  is 
not  pervaded  by  a  corresponding  nerve  fibre. 

4.  The  vessels  (capillary  and  lymphatic)  of  the  nerves  are  dis- 
persed in  their  neurilemma. 

[Pacinian  bodies,  corpuscles.  Observed  by  Pacini  in  1831. 
"  Small  corpuscles  or  globules,  of  an  elliptical  figure  to  the 
eye,  dull  white  or  opalescent,  of  about  two-thirds  of  a  line  long, 
lying  attached  to  the  digital  branches  of  the  median  and  ulnar 
nerves."  They  are  also  found  along  the  nerves  of  the  sole  of  the 
foot. — See  the  article  in  Cycl.  of  Anat.  and  Physiol.]. 

613.  The  Central  parts , 

brain  and  spinal  cord,  consist  of  the  same  elements  as  the  peri- 
pheral. The  primitive  fibres  and  ganglion  globules  are  accumu- 
lated in  masses,  and  united  into  definite  shapes,  which  are  not 
separated  from  one  another  by  means  of  external  sheaths. 

The  white  substance  consists  of  fasciculi  of  primitive  fibres 
which  are  continued  from  the  nerves,  interlace,  decussate,  and 
either  pass  through  the  gray  substance  of  the  central  organs  or 
receive  it  between  them.  According  to  Valentin  there  are,  even 
here,  no  terminations  to  the  nerves  ;  but,  as  in  the  peripheral, 
only  places  for  their  reflection  ;  so  that  every  primitive  fibre  is 
closed  in  a  circular  manner,  and  by  that  it  might  be  decided  that 
in  the  central  organs  no  other  fibres  exist  as  such  which  continue 
into  the  nerves. 

The  gray  substance  exists  under  different  colours,  partly  as  ex- 
ternal (the  cortex  of  the  brain),  partly  as  internal  (in  the  spinal 
marrow)  masses,  in  the  deep  layers  of  which  (in  the  brain)  fibres 
are  also  found,  together  with  the  ganglion  globules  (Lauth). 

1.  The  spinal  cord  sends  off  from  thirty-one  to  thirty-two  nerves 
upon  either  side,  the  posterior  roots  of  which  are  subservient  to 
sensation,  those  of  the  anterior  to  motion.  Higher  upwards  the 
fibres  of  these  roots  decussate  in  the  medulla  oblongata,  as  the 
right  pass  off  to  the  left,  and  the  reverse.  From  this  point  (almost) 
all  the  fibres  pass  upwards  into  the  brain  through  Pom  Varolii  in 
the  crura  cerebri,  and  partly  into  the  cerebellum. 

According  to  Budge,  the  spinal  cord  contains  motor  fibres  in  its 


THE  NERVES.  361 

whole  thickness  ;  according  to  Valentin,  the  nervous  fibres  of  the 
flexor  muscles  are  situated  in  the  anterior  columns  of  the  spinal 
cord  and  pass  over  those  of  the  extensor  muscles  in  the  posterior. 
The  motor  and  sensitive  nerves  of  the  viscera  pass  along  in  the 
spinal  marrow  (See  IV.  sympathicus). 

2.  The  brain  sends  off  twelve  pairs  of  nerves.  These  are, 
partly,  nerves  of  sensation  (and  of  the  senses),  partly  nerves  of 
motion,  and  partly  of  both  together  (mixed  nerves).  They  are 
abstractedly  of  the  three  nerves  of  the  higher  senses  (for  smell, 
sight,  hearing),  which  may  be  considered  as  parts  of  the  brain,  in 
accordance  with  the  spinal  nerves,  and  the  skull  has  been  regarded 
as  consisting  of  three  vertebrae.  Accordingly  there  might  be  an 
anterior  (n.  oculo-motor,  abducens  trigeminus]  and  a  posterior  in- 
tervertebral  nerve  of  the  skull  (N.  glossopharyng.,  vagus  with 
accessorius  and  hypoglossus).  We  cannot,  however,  refer  to,  in 
all,  an  anterior  and  posterior  root.  They  arise  from  the  posterior 
part  of  the  basis  of  the  brain. 

The  hemispheres  of  the  cerebrum,  carp.  caUosum,  hypophysis 
and  pineal  gland,  are  the  means  neither  of  motion  nor  sensation  ; 
it  appears,  accordingly,  as  if  the  mental  functions  (thought)  were 
dependent  upon  them. 

In  the  cerebellum  the  nerves  of  the  large  intestines,  of  the  blad- 
der and  organs  of  generation,  terminate;  in  the  optic  tubercles  and 
striated  bodies  those  of  the  stomach  and  small  intestines  ;  in  the 
corpora  quadrigemina  (by  going  through  Pans  Varolii)  the  nerves 
of  the  trunk. 

The  vessels  of  the  central  parts  are  very  fine,  and  consist  of  the 
primary  vascular  coat  only  ;  they  form  close  rete  in  the  gray,  but 
are  more  sparingly  diffused  in  the  white  substance.  They  spread 
out  on  the  surface  in  the  pia  mater  (see  after),  and  from  here  sup- 
ply the  substance  (and  from  the  processes  which  the  last  sends  into 
the  cerebral  cavities,  as  plexus  choroidei).  The  arteries  quickly 
pass  into  capillary  vessels.  Lymphatic  vessels  are  not  known  in 
the  substance,  but  probably  in  the  envelopes.  For  the  membranes 
of  the  brain,  see  Brain  and  Spinal  Marrow,  §  624. 

614.  The  Brain,  Encephalon, 

is  a  mass  consisting  of  nervous  substance,  which,  surrounded  by 
three  concentric  membranes,  fills  up  the  cranial  cavity,  and  con- 
tains, in  its  interior,  four  spaces  connected  together.  Its  surface  is 
covered  by  a  gray  (cortical)  substance,  from  one  to  one  and  a  half 
lines  thick,  the  (medullary)  substance  lying  under  that  is  white. 


362  SPECIAL  ANATOMY. 

Weight :  from  three  and  a  half  to  four  pounds  and  one-third ; 
greatest  longitudinal  diameter,  six  inches  ;  transverse,  five  inches  ; 
vertical,  four  and  three-quarter  inches.  It  is  divided  into  the  three 
following  portions : 

615.  1.  The  great  brain,  cerebrum,  fills  up  the  cranial  cavity, 
with  the  exception  of  thefossce  occipitales  inferiores,  is  semi-oval, 
four  inches  deep,  about  three  pounds  weight,  and  rests  with  its  basis 
upon  the  anterior  and  central  cranial  fossae,  and  upon  the  tentorium 
cerebelli.  A  deep  fissure  divides  the  cerebrum  into  two  lateral 
halves  or  hemispheres,  of  equal  size,  each  of  which  contains,  in 
the  interior,  a  cavity  (ventriculus  lateralis),  consists  of  three  lobes, 
and  which,  on  the  surface,  are  distinguished  by  the  convolutions, 
gyri,  like  intestines,  which  are  limited  by  irregular  fossae  (suki) 
not  very  deep,  and  which  do  not  generally  correspond  upon  the 
two  hemispheres.  On  the  inferior  surface  of  the  brain  we  see,  in 
the  middle  from  before  to  behind,  proceeding  from  the  centre  of  the 
brain,  also  before  and  between  the  crura  cerebri,  a  perforated  place, 
the  substantia  perforata  media,  before  it  two  roundish  tubercles, 
corpora  mamillaria,  before  these  a  gray  enlargement,  tuber  cine- 
reum,  elongated  into  the  infundibulum  to  which  the  glandula  pi- 
tuitaria  is  connected.  Before  the  tuber  cinereum  the  decussation 
of  the  optic  nerves  presents  itself.  Upon  both  sides  of  the  basis 
cerebri  we  see  the  fossa  Sylvii,  which  separates  the  anterior  from 
the  middle  cerebral  lobes,  and  the  origin  of  the  twelve  pairs  of 
nerves,  of  which  the  olfactory  nerve  is  situated  in  a  particular  ex- 
cavation. Behind  that  part  of  the  hemispheres  which  is  situated 
over  the  cerebellum  is  a  little  hollowed  out.  On  the  external  sur- 
face of  the  brain  we  see  a  fissure,  the  continuation  of  the  fossa 
Sylvii,  which  separates  it  into  a  horizontal  and  ascending  portion. 
The  superior  surface  presents  the  great  longitudinal  fissure,  fissura 
cerebri  longitudinalis,  and  the  irregular  gyri  and  sulci.  On  the 
internal  surfaces  of  the  hemispheres,  which  are  turned  towards 
each  other,  there  is  a  tolerably  constant  gyrus  fornicatus  which 
forms  an  arch  around  the  great  cerebral  commissure.  We  gene- 
rally admit  three  lobes  on  each  hemisphere ;  but  according  to 
Arnold  and  others  we  must  receive  five,  an  anterior,  middle,  supe- 
rior, posterior,  and  the  Insula  or  lobus  intermedius  (according  to 
Burdach,  lobus  caudicis).  The  last  presents  the  gyri  breves. 

'  616.  2.  The  small  brain,  cerebellum,  is  situated  in  the  inferior 
cranial  fossa,  covered  by  the  tentorium.  It  projects  a  little  behind 
the  posterior  cerebral  lobes,  is  roundish  and  flattened  from  above 
downwards ;  its  transverse  diameter  measures  four  inches,  its  Ion- 


THE  NERVES.  363 

gitudinal  two  and  a  half,  the  vertical  two.  Weight,  four  ounces  ; 
it  is  said  to  be  greater  in  the  female  than  in  the  male  (Cuvier).  In 
proportion  to  the  size  of  the  great  brain  in  children  =1  : 20,  in  the 
adult  =1  :7.  Its  superior  surface  is  divided  by  a  projecting  line 
from  before  to  behind  into  two  sloping,  its  inferior  by  a  fissure, 
vattecula,  into  two  rounded  lateral  halves,  hemisphceria  cerebelli, 
which  are  convex  below,  and  have  between  them  at  their  posterior 
circumference  a  triangular  space,  which  receives  the  tentorium  and 
the  crista  occipitalis  interna.  The  anterior  boundary  presents  a 
crescentic  excavation,  incisura  marginalis  anterior^  which  sur- 
rounds the  corpp.  quadrigemina  ;  before  it  protuberantia  annula- 
ris  is  situated;  and  from  it  proceed  the  crura  cerebelli  ad  pontem, 
ad  corpp.  quadrigemi?ia  and  ad  medullam  oblongatam.  Between 
the  two  hemispheres  the  process,  vermiform,,  is  situated,  which  is 
divided  by  a  transverse  fissure,  sulcus.  transvers.  Reilii,  into  a 
superior  and  inferior  portion,  and  forms  the  roof  of  the  fourth  ven- 
tricle. Other  transverse  fissures  give  to  the  surface  of  the  lesser 
brain  a  laminated  appearance. 

617.  3.  The  central  portion  of  the  brain,  mesencephalon,  isth- 
mus encephali^  consists  of  several  parts  at  the  basis  and  in  the  inte- 
rior of  the  brain,  which  unite  together  the  large  and  small  brains 
and  the  spinal  marrow.     To  this  belong :  medulla  oblongata,  pans 
Varolii,  crura  cerebri  and  corpp.  quadrigemina. 

Parts  of  the  Central  and  Great  Brain. 

618.  I.  On  the  Basis. 

1.  The  medulla  oblongata,  the  conical  enlargement  at  the  supe- 
rior extremity  of  the  spinal  marrow  (bulbus  medulla),  the  imme- 
diate continuation  of  which  it  is,  and  with  which  it  forms  an  obtuse 
angle,  is  from  fourteen  to  fifteen  lines  long,  nine  broad,  sk  thick ; 
it  commences  at  the  foramen  magnum  and  terminates  at  thepons 
Varolii,  as  its  anterior  surface  rests  upon  the  clivus.  It  contains 
white  and  gray  substance  intermingled,  and  presents  on  its  anterior 
surface  a  longitudinal  fissure  which  goes  as  far  as  the  pons,  and  a 
posterior  which  expands  into  the  fourth  cerebral  ventricle.  On 
each  half,  which  arises  by  this  arrangement,  we  see  three  enlarge- 
ments : 

a.  Corpora  pyramidal,ia,  the  anterior  pyramids,  lying  close  to- 
gether. Each  of  these  is  a  white  narrow  (below  one  line  and  a 
half,  above  two  lines)  fasciculus  of  fibres  which  decussate  with  the 
fibres  of  the  other  side  in  its  inferior  third  only,  and  above  pass  into 
thepons  Varolii. 


364  SPECIAL  ANATOMY. 

b.  Corpora  olivaria,  much  shorter  than  the  last  (six  lines  long), 
on  the  outer  side  of  which  they  are  placed,  directed  downwards 
and  inwards.     Above  they  are  separated  from  pons  Varolii  by  a 
deep  fossa,  below  they  are  bounded  by  arched  fibres,  internally  by 
the  roots  of  N.  hypoglossus,  and  they  reach  as  far  as  the  central 
line.     On  their  outer  border,  fasciculi  of  fibres  ascend  from  the 
spinal  cord  (funiculus  siliquce  externus),  and  pass  through  pons 
Varolii  to  the  sides  of  corpp.  quadrigemina  (crura  ad  corp.  qua- 
drig.},  and  form  the  superior  roof  of  the  aquceductus  Sylvii. 

The  posterior  surface  of  the  medulla  oblongata  is  covered  by  the 
cerebellum,  and  presents  above  a  V-shaped  fissure,  calamus  scrip - 
torius,  which  forms  the  anterior  wall  of  the  fourth  ventricle ; 
externally  the 

c.  Corpora  restiformia  s.  crura  cerebelli  inferiora,  the  posterior 
pyramids,  the  superior  extremity  of  which  is  enlarged  in  the  form 
of  a  nipple,  and  are,  in  a  manner,  the  roots  of  the  cerebellum,  con- 
sist of  tortuous  fibres. 

2.  Pons   Varolii  s.  protuberantia  annularis,  white,  cubical, 
placed  above  med.  oblong,  from  the  centre  of  clivus  to  the  proc. 
clinoid.  postt.,  in  a  depression  before  the  small  brain,  below  the 
corpp.  quadrigem.  and  the  cerebrum.    In  the  middle  of  the  inferior 
surface,  directed  obliquely  upwards  and  forwards,  it  presents  a 
longitudinal  sulcus  (for  art.  basilaris),  on  the  sides  of  which  the 
prolongations  of  the  corpp.  pyramidalia  proceed ;  farther,  trans- 
verse fibres,  from  which  the  crura  cerebelli  pass  off;  and  from  be- 
tween which  N.  trigeminus  arises.     From  the  anterior  border,  the 
crura  cerebri  pass  forth  ;  from  the  lateral,  the  crura  cerebelli  ;  at 
the  posterior,  the  pyramids  enter.     The  superior  surface  forms  the 
floor  of  the  fourth  ventricle. 

3.  Crura  cerebri,  two  thick,  cylindrical,  white  cords,  six  lines 
long,  diverging  from  the  anterior  border  of  the  pons,  forwards,  up- 
wards and  outwards  to  the  great  brain,  where  they  become  broader 
and  flatter,  and  are  embraced  by  tractus  nerv.  opticorum.     Below 
and  at  the  sides  free,  they  unite  above  with  the  corpp.  quadrige- 
mina and  crura  cerebelli  superiora.     They  form  the  continuations 
of  the  pyramids.     Between  them  is  a  triangular  space  which  is 
filled  up  by  the  three  following  parts : 

4.  Substantia  perforata  media,  basis  ventriculi  3 ;  this  gray 
perforated  plate  consists  of  two  triangular  fasciculi  (separated 
from  the  crura  cerebri  by  a  black  line),  and  forms  the  poste- 
rior part  of  the.  floor  of  the  third  ventricle.     Here  arises  N. 
oculomotorius. 

5.  Corpora  mamillaria  s.  bulbi  fornicis,  two  half  globules,  the 


THE  NERVES.  365 

size  of  a  pea,  externally  white,  internally  gray,  (in  the  foetus,  one 
only,)  separated  by  a  fissure,  united  by  means  of  gray  matter ; 
they  form  the  extremities  of  the  anterior,  descending  crura  of  the 
for  nix. 

6.  Tuber  cinereum,  a  gray,  soft  mass  in  the  triangular  space 
between  (and  before)  the  corp.  mamittar.  and  tracti  optici,  the  floor 
of  the  third  ventricle;  above  it  lies  the  commissura  anterior ; 
under  it  the 

7.  Infundibulum,  a  reddish,  hollow  body,   directed  obliquely 
forwards,  two  lines  long,  to  which 

8.  Hypophysis  (s.  glandula  pituitaria)  is  attached.    It  consists 
of  an  anterior  larger  and  whiter,  and  a  posterior  smaller  and 
yellowish  lobule,  lies  in  the  sella  turcica,  is  very  vascular,  and 
weighs  from  five  to  ten  grains  ;  on  its  sides  the  plexus  caver- 
nosi.     In  the  fetus  and  the  lower  animals  hollow. 

9.  Tractus  nervorum  opticorum,  two  white,  flat  bands,  fifteen 
lines  long,  arising  behind  from  thalamus  oplicus  and  corp.  genicu- 
latum  ;  they  wind  around  the  crura  cerebri  on  the  outside  and  be- 
hind, at  the  place  where  they  enter  into  the  brain,  then  pass,  on  the 
outer  side  of  tuber  cinereum,  inwards  and  forwards,  and  unite  be- 
fore the  tuber  cinereum. 

10.  Chiasma  nervorum  opticorum,  a   quadrangular  flattened 
ganglion,  the  internal  fibres  of  which  decussate,  while  the  external 
pass  directly  forwards;  it  lies  before  the  hypophysis,  behind  the 
lamina  cribrosa.     Its  anterior  border  is  united,  by  means  of  a 
vertical  lamina  terminalis,  with  the  anterior  commissure,  which  is 
situated  above  it.     From  this  the  optic  nerves  pass  off. 

1 1 .  Lamina  cribrosa  cerebri  s.  substantia  perforata  anterior,  a 
thin,  white  plate  before  the  ckiasma,  perforated  by  many  vessels, 
bounded  in  front  by  the  commencement  of  corp.  callosum.     From 
it  the  olfactory  nerves  arise. 

619.     II.  The  Azygos  Parts  in  the  centre  of  the  Cerebrum. 

1.  Corpus  callosum  s.  commissura  maxima,  a  white  flat  band, 
three  and  a  half  inches  long,  eight  to  ten  lines  broad,  and  two  to 
three  thick,  in  the  centre  between  the  great  hemispheres  (one  inch 
distant  from  their  anterior,  two  from  their  posterior  border),  visible 
from  above  in  the  deep  longitudinal  fissure,  consisting  of  transverse 
fibres  (stria  transverse^  Wittisii).  Its  superior  arched  surface 
presents  two  longitudinal  striae  (strice  longitudinaks  Lancisii), 
between  which  a  slight  depression  is  found  (raphe) ;  upon  it  the 
artt.  callosfB  and  the  free  border  offalx  cerebri  are  situated.  Its 


366  SPECIAL  ANATOMY. 

inferior  concave  surface  forms  upon  either  side  the  roof  of  the  la- 
teral ventricle,  is  situated  in  the  middle  line,  in  front,  above  the 
septum ;  behind^  above  the  fornix.  Its  posterior  thick  and  free 
extremity  (spknium)  with  the  lyra  s.  psalterium,  that  is,  the  in- 
ferior transverse  fibres,  covers  the  corpp.  quadrigemina  and  coro- 
narium,  and  touches  the  monticulus  cerebetti.  Its  anterior  extre- 
mity is  reflected  upon  itself  (genu),  and  passes  from  above  down- 
wards and  from  before  backwards,  terminating,  in  a  beaked  man- 
ner (rostrum),  before  the  commissura  anterior  at  the  basis  of  the 
cerebrum. 

2.  Septum  pellucidmn,  the  translucent  partition,  a  thin,  trian- 
gular, vertical  plate  higher  before  than  behind,  expanded  between 
the  anterior  part  of  corp.  callosum  and  the  fornix,  consists  of  two 
layers  (between  which  the  canal,  septi  pellucidi  [fifth  ventricle]), 
and  forms  the  internal  walls  of.  the  lateral  ventricle. 

3.  Fornix,  a  )(  shaped  medullary  arch,  passing  in  the  direction 
of  the  corp.  callosum,  consists  of  two  laminae  which,  beneath  the 
septum,  are  placed  close  to  one  another,  between  and  upon  the 
optic  tubercles,  and  before  and  behind  separate  from  each  other. 
Its   anterior  crura  (columnce)  incline    downwards  and  forwards 
around  the  optic  tubercles,  in  consequence  of  which  a  semilunar 
space,  foramen  Monroi,  arises  (through  which  the  lateral  com- 
municates with  the  third  ventricle).     They  then   curve  between 
thalamus  and  corpus  striatum  to  the  corp.  mammillaria,  and, 
from  these,  may  be  traced,  as  far  as  tcenia  semicircularis  and 
corpp.  quadrigemina,  backwards,  to  the  optic  tubercles.     Its  pos- 
terior crura  are  more  widely  separated  from  one  another  (between 
them  the  lyra),  and  curve  round  the  posterior  surface  of  the  tha- 
lamus outwards  and  downwards  to  the  pedes  Hippocampi  in  the 
lateral  ventricles. 

4.  Conarium  s.  glandula  pinealis,  a  conical  reddish-gray  cor- 
puscle (four  lines  long,  two  to  three  lines  broad),  between  the  two 
anterior  of  the  corpp.  quadrigemina,  invested  with  Pia  mater, 
surrounded  by  Vv.  Galeni,  is  situated  behind  the  commis.  poste- 
rior of  the  third  ventricle,  below  the  lyra,  its  free  apex  directed 
backwards.     It  is  connected  by  means  of  two  crura  with  the  optic 
tubercles,  is  sometimes  hollow,  and  contains  the  yellow  and  white 
sand  of  the  brain  (phosphate  and  carbonate  of  lime). 

5.  Corpora  quadrigemina  s.bigemina  (lobus  opticusofihe  lower 
animals),  are  the  two  larger  anterior  (nates)  and  the  two  smaller 
posterior  (testes)  elevations  which  are  situated  in  a  quadrangle  of 
ten  lines  long  and  eight  broad  at  the  superior  extremity  of  the 
crura  cerebri  above  the  commencement  of  aquceduct.  Sylvii  (hence 


THE  NERVES.  367 

pons  Sylvii)  under  the  splenium  fornwis,  before  the  cerebellum, 
behind  the  optic  tubercles.  In  front  fibres  pass  to  the  optic  tuber- 
cles and  the  commissura  posterior  of  the  third  ventricle,  behind 
they  enter  the  crura  cerebelli  superiora. 

620.  The  Ventricles  of  the  Brain. 

1.  The  lateral  ventricles,  ventriculi  laterales  s.  tricornes.  Each 
hemisphere  of  the  cerebrum  contains  a  large  L-shaped  cavity, 
which  is  situated  rather  towards  the  basis,  separated  from  the  other 
by  the  septum  pettucidum  andforniz  only,  and  in  communication 
by  means  of  theforam .  Monroi.  It  is  partly  filled  with  the  plexus 
choroideus.  Its  roof  (centrum  semiovale  Vieussens)  consists  of 
the  transverse  fibres  of  the  corp.  ccdlosum.  We  distinguish  four 
portions : 

a.  Cetta  lateralis,  the  lateral  chamber,  is  the  central,  superior, 
longitudinal  space,  which  is  deeper  internally  in  the  angle  between 
septum  andfornix  on  the  one  side,  and  thalamus  and  corp.  stria- 
turn  on  the  other,  than  externally.  Corp.  striatum  and  thalamus 
form  its  floor. 

1.  Corpus  striatum,  a  club-shaped,  gray  mass,  perforated  by 
veins,  which  passes  backwards  into  a  point,  and  is  situated  in 
a  deep  fossa  on  a  plane  with  the  insula  (foss.  Sylvii),  on  the 
outer  side  of  tludamus.     It  is  traversed  by  white  striae  which 
penetrate  the  thalamus. 

2.  Thalamus  nervi  optici,  the   optic   tubercle.     Its  superior, 
vaulted,  longitudinal  surface  looks  into  the  lateral  ventricle 
(covered  by  plexus  choroides) ;  before  it  the  anterior  crus  of 
iheforniz  curves  downwards ;  the  corpus  striatum  surrounds 
it  externally  (separated   by  stria  cornea  [tienia  semicircu- 
laris]),  with  which  it  forms  a  centrum  for  the  hemisphere, 
and  is  associated  with  that  of  the  thalamus  of  the  other  side 
by  means  of  commissura  mollis ;  its  internal  vertical  sur- 
face forms  the  lateral  wall  of  the  third  ventricle ;  beloiv,  it 
receives  the  crus  cerebri  in  an  excavation,  and  behind  and  in- 
ternally it  joins  the  posterior  commissure.     Quite  internally 
on  the  posterior  surface,  above  the  crus  cerebri,  external  and 

.  internal  to  the  corpp.  quadrigemina,  are  situated  upon  either 
side  the  two  geniculate  bodies,  the  corp.  geniculatum  inter- 
num  which  passes  into  one  of  the  anterior,  and  externum 
which  blends  with  one  of  the  posterior  of  the  corp.  quadri- 
gemina. 

3.  Stria  cornea  \tcenia  semicircularis],  a  white,  band-like,  me- 


368  SPECIAL  ANATOMY. 

dullary  stripe  between  corp.  striatum  and  thalamus  ;  above 
which  is  situated  the  lamina  cornea,  that  is,  a  thickening  of 
the  internal  membrane  of  the  ventricle  (with  the  vena  striata). 

b.  Cornu  anterius.     It  extends  from  the  lateral  chamber  before 
the  clavate  extremity  of  corpus  striatum,  forwards,  downwards, 
and  outwards,  into  the  anterior  lobe  of  the  brain.     The  anterior 
cornu  is  bounded  before  by  the  genu  of  corp.  callosum,  internally 
by  septum  pellucidum. 

c.  Cornu  posterius  s.  cavitas  digitata  passes  from  the  posterior 
extremity  of  the  lateral  chamber  into  the  posterior  lobes  of  the 
brain,  is  externally  convex,  behind  pointed,  very  insignificant,  is 
situated  near  the  basis,  and  presents  on  its  inferior  wall  a  gray 
projection  [Hippocampus  minor],  which  depends  upon  a  convo- 
lution on  the  base  of  the  brain,  and  is  covered  by  white  medullary 
striae  which  give  to  it  a  digitate  appearance  (pes  hippocampi  mi- 
nor}, and  pass  on  to  blend  with  thefornix. 

d.  Cornu  descendens  s.  inferius,  extends  in  an  arched  form  from 
the  posterior  extremity  ofcella  lateralis,  around  the  optic  thalamus 
and  crus  cerebri,  forwards  and  downwards  into  the  middle  cere- 
bral lobe.     Its  superior  concave  wall  is  placed  close  upon  the  in- 
ferior convex,  which  forms  the 

Pes  hippocampi  major,  cornu  Ammonis.  This  is  a  cylindrical 
enlargement,  thicker  before  and  curved  within,  on  the  internal 
concave  border  of  which  a  narrow  thick  edging,  tcenia(s.fimbria), 
and  under  that  a  gray,  notched  stripe,  fascia  dentata,  is  found. 
The  external  surface  consists  of  whiter,  the  internal  of  gray,  spiral, 
convoluted  substance  ;  the  white  passes  on  to  the  corpus  callosum 
andforniz;  the  gray  depends  upon  a  convolution  at  the  basis  of 
the  brain.  (Compare  pes  hippoc.  minor.} 

2.  The  middle  cerebral  ventricle,  ventriculus  tertius,  a  narrow 
fissure  in  the  middle  line,  above  and  behind  broader,  near  the  basis 
of  the  cerebrum,  lying  between  the  two  optic  thalami  which  form 
its  lateral  walls,  and  are  covered  with  gray  matter.  Its  floor  is 
curved  downwards;  its  posterior  portion,  white  and  strong,  in- 
clined forwards,  corresponds  to  the  space  between  the  crura  cerebri  ; 
its  funnel-shaped  centre,  to  the  corpp.  mammillaria  and  infundi- 
bulum  ;  its  anterior  portion  extends  as  far  as  to  the  posterior  bor- 
der of  the  chiasma. 

Anterior  wall,  formed  by  crura  anter.fornicis,  before  this  com- 
missura  anterior  and  lamina  terminalis,  presents  the  for  am. 
Monroi.  The  posterior  wall,  formed  by  corpp.  quadrigem.,  com- 
missur a  posterior,  presents  under  this  the  aditus  ad  aquceductu  m 
Sylvii.  The  roof  is  formed  byfornix  zu&lyra. 


THE  NERVES.  369 

Openings : 

1.  Foramen  Monroi,  in  front  and  above,  leads  into  the  right 
and  left  lateral  ventricles. 

2.  Aditus  ad  aquceductum  Sylvii,  behind. 

3.  Aditus  ad  infundibulum,  below,  leads  into  the  infundibulum. 
Commissures : 

1.  C.  anterior,  a  white  cylindrical  cord,  passing  before  the  an- 
terior crura  of  theforniz  from  one  hemisphere  to  the  other. 
From  it  the  lamina  terminalis  passes  vertically  downwards 
to  the  chiasma. 

2.  C.  Posterior,  smaller  than  the  last,  in  other  respects  like  it, 
uniting  the  two  thalami,  lying  before  the  corpp.  quadrigemina, 
under  the  pineal  gland  with  which  it  is  united. 

3.  C.  mollis,  a  gray  band  stretched  like  a  bridge  between  the 
anterior  extremities  of  the  thalami,  passes  transversely  through 
the  centre,  nearer  to  the  roof  than  to  the  floor  of  the  cerebral 
ventricles. 

3.  The  Aqueduct  of  Sylvius  [iter  a  tertio  ad  quartum  ventri- 
culum],  a  three-sided  canal,  passes  from  the  posterior  extremity 
of  the  third  ventricle,  backwards  and  downwards,  under  the  pineal 
gland  [its  commissure  and  the  posterior  commissure]  and  the  corpp. 
quadrigemina,  above  the  centre  of  the  crura  cerebri  to  the  fourth 
ventricle. 

4.  The  fourth  ventricle,  ventriculus  quartus  s.  cerebelli,  a  rhom- 
boidal  space  between  the  cerebellum  and  the  isthmus,  the  former 
of  which  forms  the  posterior  wall  (roof),  the  latter  (the  floor).     It 
is  broad  in  the  centre,  in  front  narrow,  and  it  passes  backwards 
into  a  point.     The  floor,  that  is,  above,  the  posterior  surface  of  the 
pans  Varolii,  below,  that  of  the  medulla  oblong.,  is  rhomboidal, 
and  bounded  laterally,  below,  by  corpp.  restiformia.     The  roof 
consists  above  of  the  crura  cerebelli  superiora  and  valvula  magna, 
in  the  centre  of  the  vermis  inferior  ;  below,  of  a  fibrous  plate 
from  the  neurilemma  of  the  spinal  marrow.     The  superior  angle 
receives,  below,  the  valvula  magna  of  aquceductus  Sylvii ;  the 
lateral  angle  reaches  to  the  corpus  rhomboid,  of  the  cerebellum  ; 
the  inferior  angle  presents  a  fissure  between  medulla  oblongata 
and  cerebrum,  through  which  the  fluid  in  the  fourth  ventricle  com- 
municates with  that  beneath  the  arachnoidea  of  the  spinal  cord. 
The  interior  is  smooth,  covered  with  a  serous  membrane,  and 
contains,  like  the  other  cerebral  ventricles,  a  plexus  choroideus. 

24 


370  SPECIAL  ANATOMY. 

The  Parts  of  the  Cerebellum. 

621.  I.  On  the  hemispheres. 

1.  The  superior  lobes.    They  are,  an  anterior  layer,  and  a  poste- 
rior crescentic  ;  both  are  separated  by  the  sulcus  horizontalis  from 

2.  The  inferior  lobes.     These  exist  in  greater  number  according 
as  they  are  arbitrarily  divided.     We  usually  distinguish  an  anterior 
(lob.  biventer),  posterior,  middle  lobes,  and 

a.  Tonsilla  (s.  lobus  medulla  oblongatce)  ;  lying,  generally,  in- 
ternally in  a  depression  on  the  anterior  and  middle  lobes,  be- 
hind and  close  to  the  corp.  restiforme  of  its  side,  surrounding 
with  its  internal  concave  surface  the  medull.  oblongata,  and 
extending,  with  its  anterior  extremity  inwards,  into  the  fourth 
ventricle. 

b.  Flocculus  (lobul.  nervi  pneumo-gastrici),  placed  behind  the 
crus  cerebelli  ad  pontem  and  2V.  vagus,  below  Nn.  facialis 
and  acousticus,  before  the  tonsilla. 

3.  The  medullary  body  of  the  hemispheres.     In  the  interior  of 
each  hemisphere  we  find  a  white  nucleus,  from  which  fifteen  to  six- 
teen principal  branches  pass  off,  which   again  ramify,  are  sur- 
rounded by  a  brown  substance,  and  thus  produce  the  arbor  vitce. 
From  the  central  point  of  the  vertical,  olive-shaped  nucleus,  corpus 
rhomboideum  s.  ciliare,  the  indented  surface  of  which  is  formed  of 
yellow  arid  gray  substance,  pass  out — 

4.  The  crura  cerebelli,  of  which  there  are  three  upon  either  side. 

a.  C.  cerebelli  superior  a  (s.  ad  corp.  quadrigem.,  ad  testes),  are 
placed  before  the  superior  vermis,  pass,  united,  through  valv. 
Vieussens.,  converging  upwards  and  forwards  under  ihecorpp. 
quadrigem.,  to  the  cerebrum. 

b.  C.  cerebelli  inferiora  s.  corpp.  restiformia,  pass  from  the 
medull.  oblong,  (which   see),  forwards  and  upwards,  to  the 
hemispheres  of  the  cerebellum. 

c.  C.  cerebelli  lateralia  s.  ad  pontem.     They  are  situated  before 
the  two  preceding,  at  the  anterior  circumference  of  the  cere- 
bellum, and  pass  over  internally  into  the  pons  Varolii. 

622.  II.  The  Vermiform  processes,  Vermis, 

is  the  central  portion  of  the  cerebellum,  divided  by  the  sulcus  hori- 
zontalis into  a  superior  and  inferior  portion,  contains,  likewise,  in  its 
interior,  a  medullary  nucleus,  from  which  medullary  striae  pass  into 
its  two  divisions. 

1 .  The  superior  vermiform  process,  vermis  superior,  projects  in 


THE  NERVES.  371 

the  middle  line  on  the  superior  surface  of  the  cerebellum,  like  a 
crest,  and  presents : 

a.  Mons  cerebeUi  t  that  is  to  say,  the  largest  portion  of  the  vermis 
superior ;  its  summit  (cacumen)  is  situated  rather  in  front, 
under  the  spknium  corp.  callosi  ;  behind  (declive)  and  at  the 
sides  it  is  sloping. 

b.  Lobulus  centralis^  the  smallest  part,  is  placed  in  the  anterior 
excavation  of  the  cerebellum,  behind  the  corpp.  quadrigemina, 
below  the  mons,  above  the  anterior  valve. 

c.  Folium  cacuminis,  is  placed  in  the  posterior  excavation,  trans- 
versely behind  the  mons,  and  unites  the  two  posterior  lobes  of 
the  hemisph.  cerebeUi. 

2.  The  inferior  vermiform  process,  vermis  inferior,  lies,  curled 
up  like  a  worm,  in  the  longitudinal  fossa  (vallecula)  between  the  in- 
ferior lobes  of 'hemisph,  cerebeUi,  into  which  it  passes,  like  the  vermis 
superior  ;  behind  and  above  pons  and  medutt.  oblongata.     Four 
prolongations  pass  off  from  it  (branches) : 

a.  An  anterior,  the  apex,  in  the  anterior  excavation,  enlarged  and 
clavate  anteriorly  (this  is,  nodulus  Melacarne) ;  it  projects 
into  the  fourth  ventricle. 

b.  Two  lateral,  passing  from  a  longitudinal  uvula  (uvula  vermis) 
in  the  central  line,  and  the  broadest  and  highest  part  of  the 
inferior  vermis,  lying  before  it  (pyramis  vermis),  into  the 
lateral  angle  of  the  fourth  ventricle. 

c.  A  posterior  (tuber  valvulce)  is  situated  in  the  posterior  excava- 
tion, and  unites  the  posterior  inferior  lobes  of  the  hemisph. 
cerebeUi. 

3.  The  great  valve,  valvula  magna  cerebri,  s.  Vieussenii,  s. 
velum  medull.  anterius,  a  thin,  semi-transparent,  gray  plate,  spread 
out  between  the  two  crura  cerebeUi  superiora.     The  anterior  con- 
vex surface  forms  the  posterior  wall  of  aqutzductus  Sylvii  ;  the 
posterior  concave  looks  towards  the  vermis  superior  ;  the  anterior 
border  is  connected  with  the  posterior  corpp.  quadrigemina  ;  the 
posterior  border  with  the  medullary  substance  of  the  vermis  in- 
ferior, above  the  nodulus  Melacarne. 

4.  The  small  posterior  valve,  velum  semilunare  s.  medullare 
posterius,  a  thin  medullary  plate,  situated  between  medulla  oblong. 
and  vermis  inferior,  the  short  central  portion  turned  freely  towards 
the  fourth  ventricle,  whilst  the  convex  external  border  is  attached 
from  the  flocculus  as  far  as  the  corpp.  quadrigemina. 

623.  The  Structure  of  the  Brain. 

The  gray  centre  of  the  medulla  spinalis  continues  into  the 


372  SPECIAL  ANATOMY. 

medulla  oblongata,  enclosing  a  canal  in  its  interior,  which  passes 
into  the  longitudinal  sulcus  of  the  sinus  rhomb. ,  in  consequence 
of.  which  this  fossa  becomes  covered  with  the  gray  substance 
(stratum,  cinereum).  In  some  places  it  is  more  particularly  col- 
lected together  (alee  cinerece  and  subst.  ferruginosa).  The  ante- 
rior crura,  of  the  gray  substance  of  the  medulla  spinalis  form  the 
(denticulated)  nuclei  of  the  olivary  bodies  (corpp.  denticulata), 
and  are  surrounded  by  white  substance,  the  posterior,  in  like  man- 
ner, the  nucleus  of  the  corpora  restiformia.  The  white  fibres  of 
the  spinal  cord  everywhere  surround  the  gray  substance  in  the 
prolongations,  form  the  pyramids  and  the  so-called  eminentice 
teretes  of  the  sinus  rhomb.,  and  cross  each  other  in  several  places 
(Decussation).  They  then  proceed  into  the  pans,  crura  cerebri, 
the  cerebellum,  and  so  forth. 

The  pedunculi  cerebelli,  passing  off  from  the  cord-shaped  bodies 
of  the  med.  oblong.,  form  with  their  white  mass  the  medullary 
centre  (meditullium  album)  of  the  cerebellum,  which  (except  in 
the  vermis)  encloses,  as  in  the  olivary  body,  a  gray  denticulated 
nucleus,  and  divides  externally  into  lobes,  which  are  again  over- 
laid with  gray  substance,  whereby  arises  the  arbor  medullaris  or 
arbor  mtce  (see  before).  The  separate  lobes  and  lobules  are,  as 
also  in  the  cerebrum,  united  together  by  means  of  arched  fibres, 
the  so-called  massa  explementi  which  fill  the  intervals  between 
them.  The  pons  consists  of  two  transverse  and  two  longitudinal 
layers  of  fibres,  between  which  the  gray  substance  is  deposited. 
The  pedunculi  cerebelli  superioris  s.  ad  corpp.  quadrigemina 
pass  away  inwards  under  this  (surrounded  upon  both  sides  by 
the  laqueus  which  passes  into  the  corp.  quadrigem.),  and  strengthen 
the  peduncles  of  the  cerebrum.  Hypophysis  cerebri,  and  particu- 
larly tuber  cinereum  .and  infundibulum,  consist  almost  entirely 
of  gray  substance,  the  nucleus  of  the  medulla  spinalis  appearing 
in  view.  The  infundibulum  has  a  hollow  in  it.  The  peduncles 
of  the  cerebrum  are  continuations  of  the  fibres  from  the  medulla 
oblongata  (from  the  pyramids,  funiculi  siliquce  of  Burdach)  and 
cerebellum.  They  consist  of  three  fasciculi :  basis,  covering 
(tegumentum),  and  cord  (laqueus),  which  are  separated  by  black 
substance  (which  passes  upon  them  into  fhe  three  cerebral 
ganglia).  The  inferior  layer  passes  into  the  corpp.  striata,  the 
superior  or  tegumentum  into  the  optic  thalami,  the  laquei  into 
the  corp.  quadrigem.,  the  white  mass  of  which  they  form.  The 
four  tubercles  have  each  four  gray  nuclei.  The  glandula  pine- 
alis  attached  to  them  has  a  granular  structure  like  that  of  the 
pituitaria,  and  consists  of  a  grayish-red  substance.  The  optic 


THE  NERVES.  373 

tubercles  have  in  the  interior  three  distinct  gray  nuclei,  one  inter- 
nal, external,  and  superior.  The  commissure  (central)  uniting 
the  optic  tubercles,  as  well  as  the  border  found  between  them  in 
the  third  ventricle,  also  consists  of  gray  substance.  Still  more 
distinct  and  larger  are  the  three  gray  nuclei  of  the  striated  bodies, 
nucleus  caudatus  lenticularis  and  tceniceformis.  The  stria  cornea 
consists  of  medullary  matter,  and  only  appears  yellow  when  look- 
ing through  a  vein.  From  the  cerebral  tubercles  the  great  me- 
dullary striae,  only,  pass  out,  the  radiatio  medullaris,  fibres, 
which,  as  they  decussate  with  those  of  the  carp,  callosum,  form 
the  hemispheres  of  the  cerebrum.  From  the  corp.  striatum  fibres 
spread  out  towards  both  sides;  in  front  and  behind  fasciculi  of 
fibres  go  into  the  fornix,  which  they  call  the  forceps.  Those 
which  cover  the  lateral  ventricles  are  called  tapetum.  The  ante- 
rior commissure  consists,  also,  of  white  and  gray  matter.  The 
corpp.  albicantia  (with  gray  nucleus)  are  the  commencements  [?] 
of  the  fornix  ;  they  pass,  as  radix  ascendens,  into  the  columetta 
fornicis.  Each  right  and  left  gives  off  a  medullary  plate,  the 
septum  pellucidum,  between  which  is  the  ventriculus  septi  pellu- 
cidi,  communicating  with  the  third  ventricle.  The  columellce  pass 
into  the  body  of  the  fornix.  This  divides  into  the  crura,  and 
passes  into  the  lateral  ventricles.  The  peripheral  part  of  the 
fornix  passes  in  an  arch  around  the  corp.  callosum,  (gyrus  forni- 
catus),  and  terminates  as,  uncus,  the  hook.  The  fibres  of  the 
crura  form  in  the  cornua  of  the  ventricles,  with  others  of  the 
corp.  callosum,  the  pes  hippocampi  major  and  minor.  The  first 
has  two  layers  of  medullary  and  two  layers  of  gray  substance ; 
on  it,  as  in  the  small,  the  gray  is  the  cortical  substance,  covered 
by  medullary  fibres.  The  fibrce  explementorice  here  also  fill  up 
the  intervals  between  the  fibres  of  the  radiatio  medullaris  cerebri 
of  the  peripheral  fornix  and  of  the  corpus  callosum.  Medullary 
lamince  do  not  only  pass  from  one  convolution  to  another  in  an 
arched  manner,  but  a  distinct  mass  also  unites  the  anterior  and 
inferior  lobes  in  the  fossa  Sylvii  (fasciculus  uneiformis.  Reil.) 

624.  The  Membranes  of  the  Brain. 

The  brain  and  spinal  cord  are  enveloped  by  three  membranes 
which  pass,  immediately,  into  one  another  at  the  foramen  magnum. 
Those  of  the  spinal  cord,  see  §  628.  The  membranes  of  the 
brain  : — 

1.  The  dura  mater,  s.  meninx  fibrosa,  a  fibrous  sac,  the  exter- 
nal rough  surface  of  which  is  firmly  attached  to  the  internal  cranial 
bones,  and  here  serves  as  periosteum  ;  the  internal,  smooth,  and 


374  SPECIAL  ANATOMY. 

moist  surface  is  inseparably  connected,  by  means  of  uniting  tissue, 
with  the  arachnoid.  It  is  connected  externally  with  the  external 
periosteum  at  tine  foramina  of  the  skull,  through  which  the  nerves 
pass  out,  and  forms  prolongations  internally  which  enter  into  the 
fissures  of  the  brain.  These  are  : 

a.  Falx  cerebri,  passing  from   the    foramen  ccecum  and  crista 
galli,  at  first  narrow,  then  broader,  in  the  centre  of  the  cranial 
vault  from  before  backwards,  where  its  base  falls  vertically 
upon  the  tentorium.     The  superior  convex  border  reaches 
from  for.  ccecum  as  far  as  protuberant,  occipitalis,  and  con- 
tains the  sinus  longitudinalis  superior;  the  inferior  concave 
touches  the  corp.  callosum  behind  only,  and  contains  a  small 
vein  (sinus  longitud.  inferior) ;  the  lateral  surfaces  separate 
the  hemispheres  of  the  cerebrum  from  one  another. 

b.  Tentorium  cerebelli,  a  septum,  placed  transversely,  is  situ- 
ated beneath  the  posterior  lobes  of  the  cerebrum  and  above 
the  cerebellum  ;  is  maintained  in  mutual  tension  with  thefah 
cerebri.     The  external  larger  circumference  attaches  behind 
to  the  linece  transvers.,  in  front  to  the  superior  angle  of  the 
petrous  bone,  and  contains  the  sinus  transversus.    Its  internal 
smaller  boundary  is  concave,  and  encircles  the  pons  Varolii 
and  corpp.  quadrigemina.     The  apices  of  the  external  cir- 
cumference are  attached  to  the  proc.  clinoid.  posterr.,  those 
of  the  internal  to  proc.  clinoid.  anteriorr.,  as  they  pass  away 
under  the  former  (decussating),  and  bound  the  fossa  pituitaria. 
The  sin.  cavernosi  are  placed  inside  them. 

c.  Falx  cerebelli  passes  downwards  from  the  protuberantia  oc- 
cipitalis  interna,  vertically,  to  the   centre  of  the  posterior 
circumference  of  foramen  magnum,  where  it  divides  into  two 
folds  for  the  lateral  parts  of  the  foramen.     The  basis  is  in 
contact  with  the  tentorium  ;  the  posterior  border  attaches  it- 
self to  crista  occipital,  poster.     The  anterior  looks  towards 
the  base  of  the  posterior  fissure,  the  lateral  surfaces  towards 
the  inner  surfaces  of  the  posterior  lobes  of  the  cerebellum. 

Structure.  The  dura  mater  consists  of  two  fibrous  layers, 
which  in  several  places  separate  from  one  another,  and  form  tri- 
angular canals  for  the  reception  of  veins :  these  are  the  sinus. 
The  fibres  of  the  layers  decussate  in  various  directions.  Between 
the  internal  layer  and  that  of  the  arachnoid,  along  the  longitudinal 
sinus,  we  find  in  the  adult  the  white  corpp.  (glandul.)  Pacchioni, 
which  often  project  into  the  sinus,  and  produce  thinning  of  the 
cranial  bones. 


THE  NERVES.  375 

625.  Sinus  venosi  dur<z  matris.  They  consist  of  the  internal 
coat  of  the  vessels,  strengthened  by  fibres  of  the  dura  mater,  and 
they  have  small  valves.  The  sinus  of  either  side  are  in  communi- 
cation, by  means  of  transverse  sinus,  with  those  of  the  other  side, 
and  by  vena  diploica  and  emissaria  Santorini  with  the  external 
cranial  veins.  They  empty  their  blood  into  the  F.  cephalica  (s. 
jugular.)  inter na. 

Vence  diploicce  are  situated  between  the  two  tables  of  the  bones 
of  the  skull  in  the  diploe,  and  enter  into  communication,  internally, 
with  the  sinus  of  the  cranial  cavity,  externally  with  the  external 
veins  of  the  head.  In  each  half  of  the  skull  four  large  branches 
are  found : 

1.  Frontalis  passes  through  a  small  foramen  at  the  incis.  supra- 
orbit,  to  the  V.  supraorbit. 

2.  Temporalis  anterior  passes  from  angid.  parietal,  anter.  to 
V.  temporalis. 

3.  Temporalis  posterior  passes  behind  and  above  proc.  mastoi.d. 
outwards,  or  opens  into  sin.  transversus. 

4.  Occipitalis,  the  largest,  opens,  in  the  neighbourhood  of  the 
middle  line  on  the  linea  semicircul.  infer.,  into  the  F.  occipitalis. 

Emissaria  Santorini  are  canals  which  connect  the  sinus  with 
the  external  veins,  through  peculiar  foramina  in  the  cranial  cavity. 
The  largest  passes  through  foram.  mastoid.,  parietale,  and  condy- 
loid.  postering. 

The  sinuses  which  meet  together  in  the  torcular  Herophili : 

1.  Sinus  longitudinalis  superior,  is  situated  in  the  superior 
border  of  the  fake  cerebri,  receives  on  either  side  seven  to  ten  Vv. 
cerebri  superr.  from  the  surface  of  the  brain,  and  some  smaller 
from  the  falx  major,  is  connected  by  means  of  foram.  parietale 
with  Vv:  occipitaks,  by  means  of  for.  coxum  (in  children),  with 
the  nasal  veins,  and  falls  from  above  into  the  torcular. 

2.  Sinus  tentorii  medius  s.  quartus,  lies  at  the  basis  of  falx 
cerebri  above  the  centre  of  the  tentorium,  from  before  to  behind, 
where  it  opens  into  the  anterior  boundary  of  torcular.     It  forms 
the  continuation  of  the  F.  magna  Galeni,  which  arises  from  the 
two  Vv.  cerebri  interni,  and  receives  at  the  anterior  part  the 

3.  Sinus  s.  F.  longitudinalis  inferior.     It  passes  along  the 
inferior  concave  border  of  fake  cerebri,  is  narrow,  and  sometimes 
absent. 

4.  Sinus  transversi  s.  laterales,  a  right  (usually  wider)  and  a 
left,  passing  off  laterally  from  torcular,  and  passing  in  the  sukus 
transversus,  at  first  on  the  posterior  border  of  the  tentorium, 
horizontally,  then  in  the  fossa  sigmoidea  downwards,  inwards,  and 


376  SPECIAL  ANATOMY. 

forwards  io  foram.  jugulare,  and  passes  into  the  bulbus  ven.  jugu- 
laris.  They  are  connected  by  means  of  an  emissarium  Sant.  in 
the  foram.  mastoid.  with  Vv.  occipital,  superjiciales,  and  receive, 
besides  the  veins  of  the  posterior  cerebral  lobes,  cerebellum  and  in- 
ternal ear,  the  sinus  petrosus  superior,  and  partly  the  occipitalis 
posterior. 

5.  Sinus  petrosus  superior,  passes  along  the  superior  angle  of 
the  petrous  bone  in  the  tentorium,  connected  at  the  apex  with  sin. 
cavern.,  and  opens  behind  and  externally  in  sin.  transvers. 

6.  Sinus  occipitalis  posterior,  descends  singly  or  double  from 
the  inferior  circumference  of  the  torcular,  in  the  falx  cerebelli  to 
the  posterior  border  of 'foram.  magnum,  opening  right  and  left  into 
the  sin.  transvers.,  and  into  plexus  venos.  spinalis. 

Torcular  Herophili  s.  confluens  sinuum,  is  the  expanded  point 
before  the  protuberantia  occipitalis  inter na,  where  the  above- 
mentioned  sinus  meet  together  with  five  (or  six)  orifices. 

Sinus  which  meet  together  in  the  confluens  sinuum  anterior, 
between  the  apex  of  the  petrous  bone  and  the  sphenoid  of  either 
side: 

7.  Sinus  petrosus  inferior,  passes  in  the  groove  between  the 
internal  inferior  border  of  os  petros.  and  the  pars  basilar.  oss.  oc- 
cipitis,  between  foram.  lacerum  posticum  and  anticum,  connected 
in   front  with  sin.  cavernos.  and  occipital,  anter.,  opening  under 
sin.  transvers.  at  the  anterior  circumference  in  the  V.  cephalica 
interna.     It  unites  the  anterior  and  posterior  sinus  of  the  basis 
cranii. 

8.  Sinus  occipitalis  anterior  (transversus)  s.  basilaris,  a  trans- 
verse venous  plexus  lying  upon  the  clivus,  uniting  the  sin.  petros. 
infer.,  as  also  the  sinus  cavernosi  of  the  right  and  left  side  with 
each  other. 

9.  Sinus  cavernosus,  situated  at  the  sides  of  the  sella  Turcica, 
between  the  apex  of  the  petrous  bone  and  thejissura  sphenoidalis, 
is  wide  and  cellular  by  means  of  numerous  fibrous  bands,  is  per- 
forated by  carotis  interna,  plexus  caroticus  and  N.  abducens,  and 
has  on  the  external  wall  the  N.  oculo-motorius. 

At  the  anterior  external  extremity  (sinus  ophtkalmicus)  it  re- 
ceives the  Vv.  ophthalmicce,V.  fossa  Sylvii  connected  with  that  of 
the  other  side  below  the  hypophysis  by  means  of  sinus  circularis 
inferior,  by  means  of  foram.  lacerum  anterius  with  plexus  ptery- 
goid.,  and  opens  behind  into  the  sinus  petrosi.  Into  it  open  : 

10.  Sinus  circularis  Ridleyi,  which  surrounds  the  pituitary 
gland  in  the  sella  turcica. 

11.  Sinus  srjheno-parietalis  s.  alee  parvcz,  lies  on  the  lateral 


THE  NERVES.  377 

wall  of  the  cranial  cavity,  between  the  anterior  and  middle  fossae, 
uniting  with  V.  meningea  media  ;  it  receives  the  anterior  diploica 
temporal.,  and  opens  into  the  sinus  cavernosus  (ophthalmicus). 

The  vessels  and  nerves  of  the  dura  mater. — Arteries:  me- 
ningece  anterior.,  from  ethmoidalis  ;  media,  from  maxillaris  in- 
terna  ;  posteriores,  from  pharyngea  ascendens,  occipitalis  and 
vertebralis. 

Veins :  Vv.  meningece,  double  for  each  artery,  open  into  the 
sinus  and  into  plexus  pterygoideus.  Lymphatics  are  wanting 
(Arnold)  ;  those  on  the  internal  wall  belong  to  the  arachnoidea. 
Nerves :  branches  from  the  first  division  oftrigeminus  and  troch- 
learis,  two  long  branches  near  the  middle  line. 

2.  Arachnoidea  (the  serous  membrane).     The  external  surface 
of  the  pia  mater  is  covered  with  pavement  epithelium,  which  ex- 
tends over  the  convolutions  of  the  brain  like  a  bridge,  passes  upon 
the  internal  surface  of  the  dura  mater,  firmly  attached  to  it  by 
uniting  tissue,  and  thus  forms  a  closed  sac,  which  does  not  enter 
the  cerebral  cavities,  lies  between  pia  and  dura  mater,  and  con- 
tains in  its  cavity,  even  during  life,  a  serous  fluid  (fluidum  cere- 
bro-spinak)  which  may  be  pressed  out  in  drops,  or  in  a  jet,  after 
piercing  it. 

3.  Pia  mater  s.  meninx  vasculosa,  the  soft,  vascular  envelope, 
a  thin  membrane  formed   of  a  vascular  rele,  and  uniting  tissue, 
lies  close  upon  the  surface  of  the  brain,  surrounded  by  the  internal 
layer  of  the  arachnoidea;  enters  the  sulci  and  ventricles,  and 
forms 

The  plexus  choroidei,  which  folded  in  a  curly  form  are  situated, 
one  in  each  ventricle,  but  continue  uninterruptedly  into  one 
another,  and  send  numerous  blood-vessels  into  the  substance 
of  the  brain.  They  are  covered  with  epithelium,  which  is 
distinguishable  from  the  ciliated  epithelium  of  the  ventricles. 

626.  Vessels  of  the  Brain. 

The  brain  is  largely  supplied  with  blood,  the  course  of  which  is 
retarded  by  the  convolutions  of  the  arteries.  These  quickly  ra- 
mify on  the  surface,  and  penetrate  thus  into  the  cortical  substance  : 
other  branches  pass  into  the  cavities,  form  the  plexus  choroidei, 
and  supply  from  this  point  the  medullary  substance. 

There  are  the  two  carotides  internee  and  vertebrales. 

The  cerebrum  is  supplied  by  branches  from  both,  the  cerebellum 
from  those  of  the  vertebral  alone;  namely  : 

a.  The  cerebrum  by  :  art.  corporis  callosi  and  its  two  Rr.  com- 


378  SPECIAL  ANATOMY. 

municantes,  art.  fossa  Sylvii,  choroidea  and  profunda 
cerebri. 

b.  The  cerebellum  by :  artt.  cerebelli  inferior,  media  and  su- 
perior. 

Veins  do  not  accompany  the  arteries ;  they  are  found  plentifully 
on  the  surface,  and  fall  into  the  sinus  of  the  dura  mater. 

a.  In  the  interior  of  the  cerebrum  pass  : 

1.  V.  choroidea,  arising  at  the  anterior  point  of  cornu  descend,  of 
the  lateral  ventricle;  it  ascends  in  the  plexus  choroid.,  the 
veins  of  which,  as  well  as  those  of  the  cornu  Ammonis,  it 
receives  and  unites  with. 

2.  V.  corporis  striati,  which  passes  from  the  stria  cornea  be- 
tween corp.  striatum  and  thalam.  n.  optici,  whilst  still  in  the 
lateral  ventricle,  to 

3.  V.  cerebri  interna  s.  magna.     This   enters  into  the  third 
ventricle  through  foram.  Monroi,  passes  into  its  plexus  cho- 
roid.  from  before  backwards,  unites  between  corp.  callos.  and 
quadrigem.  with  that  of  the  other  side  into  a  short  (two  to 
three  lines  thick)  trunk,  the  vena  Galeni,  which,  at  the  junc- 
tion oftentoriumandfalx  cerebri,  enters  into  the  last  and  the 
sinus  quartus. 

b.  The  veins  of  the  cerebellum  open  into  the  Vv.  vertebrales,  into 
the  sinus  transvers.,  petrosi  and  occipitalis  posterior. 

627.     The  Spinal  Marrow,  Medulla  spinalis,  (xusXos,  |a^iVy]^. 

This  is  the  medullary  column,  flattened  from  before  backwards, 
which  passes  downwards  into  the  canalis  spinalis  as  the  immediate 
continuation  of  the  medulla  oblongata,  surrounded,  like  the  brain, 
by  membranes.  Its  surface  is  white.  Its  length  measures,  in  the 
adult  from  fifteen  to  eighteen  inches ;  its  circumference,  at  the 
inferior  extremity  of  the  cervical  portion  =  eighteen  lines,  in  the 
lumbar  portion  =  twelve  (intumescentia  cervicalis  and  lumbalis), 
whilst  the  dorsal  portion  is  the  smallest,  on  which  account  the 
nerves  arising  from  it  are  also  the  smallest.  Its  superior  extremity 
passes  uninterruptedly  into  the  medulla  oblongata  at  the  foramen 
magnum  ;  its  inferior  termination,  on  account  of  the  long  lumbar 
and  sacral  nerves,  which  lying  close  together,  are  called  cauda 
equina,  reaches,  in  the  foetus,  as  far  as  the  sacrum,  in  the  adult  to 
the  second  lumbar  vertebra,  where  it  terminates  in  a  conical  form 
(conus  medullaris)  and  presents  two  ganglia,  as  an  exception,  only. 
On  its  anterior  and  posterior  surfaces  a  fissure  is  observable  in  the 
middle  line  (fissura  mediana) ;  at  the  base  of  the  anterior  fissure  a 


THE  NERVES.  379 

transverse  porous  commissura  alba,  but  upon  that  of  the  deeper 
posterior  fissure,  gray  substance  (comm.  grisea)  which  is  situated  in 
the  interior  of  the  spinal  marrow.  This  posterior  fissure  is, 
according  to  Arnold  and  Valentin,  in  the  fresh  medulla,  merely  a 
groove  which  only  above  and  below  passes  into  a  fissure.  We  may 
regard  the  spinal  cord  as  consisting  of  two  lateral  halves.  Each 
half  is  divided  by  a  sulcus  lateralis  (for  the  posterior  roots  of  the 
spinal  nerves)  into  a  larger  anterior  and  a  smaller  posterior  co- 
lumn, between  which  and  the  anterior  roots  of  the  spinal  nerves, 
even  a  yet  smaller,  central,  may  be  detected.  In  the  commence- 
ment of  foetal  life  a  canal  is  found  in  each  half. 

Structure  of  the  Spinal  cord.  White  substance  forms  the  ex- 
terior, cortex,  of  the  spinal  cord,  and  gray  the  nucleus. 

The  gray  substance  consists  of  ganglion  globules  (see  before). 
It  is  very  vascular,  of  various  colours  (darker  in  children),  and 
presents,  upon  a  transverse  section,  generally,  this  figure  )(,  above 
and  below  rather  ^-shaped  ;  hence  in  the  gray  substance  a  centre 
and  cornua,  or  crura,  are  described.  The  cornua  are  directed  out- 
wards towards  the  roots  of  the  spinal  nerves,  lying,  however, 
closer  to  the  posterior  surface. 

The  medullary  substance  consists  of  longitudinal  fibres  (nerve 
tubules)  which  pass  close  to,  but  independently  of,  one  another,  are 
separated  by  sheaths  (pia  mater\  at  least  the  larger,  from  each 
other,  forming  broader  or  narrower  fasciculi,  and  at  last  the  two 
(three)  columns  of  either  side,  observable  externally.  According 
to  Valentin,  the  fibres  are  the  immediate  continuations  of  the  spinal 
nerves,  which  pass  upwards,  and  the  medullary  substance  contains 
no  more  fibres  than  those  taken  together.  Free  extremities  are 
not  found.  Above  (see  Medull.  Oblong.  §  618.)  the  posterior  co- 
lumns, divided  into  three  to  four  fasciculi,  go  forwards,  obliquely 
through  the  gray  substance,  and  proceed  onwards  as  the  anterior 
pyramids,  since  the  fasciculi  of  the  two  sides  decussate  (decussa- 
tio),  whilst  the  anterior  columns  pass  directly  into  the  posterior 
pyramids  (corpp.  restiform.) 

628.  The  membranes  of  the  spinal  cord,  the  immediate  con- 
tinuations of  the  cerebral  membranes. 

1.  Dura  mater,  a  long  fibrous  cylinder,  extending  fromforam. 
magn.  to  the  termination  of  canal,  sacralis.  The  external  surface 
is  separated  from  the  vertebral  canal  by  means  of  uniting  and  adi- 
pose tissue,  in  which  the  plexus  venosi  spinales  (interni)  is  found. 
It  does  not  perform  the  office  of  periosteum  to  the  vertebrae.  The 
internal  surface  is  covered  with  the  arachnoid,  and  connected  in 


380  SPECIAL  ANATOMY. 

many  places  with  the  pia  mater.  Behind  it  is  free  ;  before  it  is 
connected  by  processes  with  lig.  longitudinakposterius.  Laterally, 
sheaths  pass  off  with  the  nerves  through  the  foramina  interverte- 
bralia,  for  the  posterior  and  anterior  roots  of  which  there  are 
openings  (two)  in  it.  The  superior  extremity  is  firmly  attached  to 
the  circumference  of  theforam.  magnum,  and  passes  into  the  dura 
mater  of  the  brain ;  the  artt.  vertebraks  perforate  it  at  this  point. 
The  inferior  extremity  forms  a  wide  sac  around  the  cauda  equina, 
divides  into  several  sheaths  (from  five  to  six)  for  the  sacral  nerves, 
and  is  firmly  connected  with  lig.  sacro-coccyg.  postic.  Vessels : 
arteries  are  rami  spinales,  the  artt.  cervicaks,  dorsaks,  lumbales 
and  sacraks.  The  veins  pass  into  the  plex.  spinales  interni. 
Nerves  have  not  yet  been  found,  the  dura  mater  is  however  sen- 
sitive. 

2.  Arachnoidea.     Between  the  dura  and  pia  mater  an  epithe- 
lium layer  is  placed,  as  in  the  brain,  which  covers  the  uniting  tis- 
sue of  the  two  surfaces,  opposed  to  each  other,  and  is  regarded  as 
a  proper  tunic ;  that  is,  the  arachnoid  membrane.     It  envelopes  the 
nerves  of  the  cauda  only,  as  far  as  iheforamm.  intervertebr.,  and 
is  then  reflected  upon  the  dura  mater.     Between  dura  and  pia 
mater  a  space  is  also  found,  filled  with  cerebro-spinal  fluid,  which 
facilitates  the  movement  of  the  spinal  cord. 

3.  Pia  mater,  is  stronger  than  that  of  the  brain,  dirty  white, 
sometimes,  in  the  cervical  region,  dotted  with  blackish  spots.     It 
forms  the  neurilemma  of  the  medulla  spinalis,  to  which  it  is  firmly 
applied,  into  the  fissures  of  which  it  enters,  and  envelopes  the 
nervous  fasciculi.     It  is  strengthened  by  fasciculi  of  fibres,  which 
are  only  lost  in  the  cranial  cavity ;  it  is  formed  besides  of  uniting 
tissue  and  vascular  rete.     On  either  side  the  thin  edge  of  the  fibrous 
lig.  denticulatum  is  attached,  from  the  free,  thicker  edge  of  which 
(from  twenty  to  twenty-one)  denticulations    pass   outwards,  and 
connect  themselves  with  the  dura  mater  in  the  intervals  between 
the  anterior  and  posterior  roots  of  the  nerves.     The  first  denticu- 
lation  is  placed  in  the  foram.  magn.  between  art.  vertebral,  and 
n.  hypogloss. ;  the  last  at  the  first  lumbar  vertebra.     From  this 
point,  the  inferior  extremity  of  conus  meduttaris,  the  pia  mater 
terminates  in  a  delicate  thread,  filum  terminate,  which  above,  only, 
contains  a  little  gray  medullary  matter,  and  is  attached  below  in 
the  sacral  canal  to  the  termination  of  the  dura  mater. 

The  Peripheral  portion  of  the  Nervous  System. 
629.         A.  The  cerebral  nerves,  nervi  cerebrates. 
There  are  twelve  pairs,  of  which  the  first,  second,  and  eighth 


THE  NERVES.  381 

are  destined  for  the  organs  of  the  senses  entirely,  the  third  and 
seventh  pass  forth  between  the  anterior  and  middle,  the  ninth  and 
twelfth  between  the  middle  and  posterior  cranial  vertebrae. 

630.  I.  N  olfactoriuSj  the  nerve  of  Smell. 

Origin  :  from  the  basis  of  the  anterior  cerebral  lobe  with  three 
white  roots ;  the  external,  longest,  passes  in  a  curve  from  the  fossa 
Sylvii  inwards  and  forwards ;  the  middle,  short,  directly  forwards, 
and  the  internal  rather  curved  inwards,  arises  from  the  substantia 
perforata  anterior.  .Each  root  consists  of  several  smaller.  They 
are  united  into  a  three-sided  nerve  (tractus  olfact.)  which  runs  in  a 
sulcus  on  the  inner  side  of  the  inferior  surface  of  the  anterior  cere- 
bral lobes,  is  soft,  striped  with  gray,  and  surrounded  by  the  pia 
mater.  It  lies  upon  the  cribriform  plate,  and  terminates  with  the : 

Bulbus  cinereus,  a  club-shaped,  flat  enlargement,  three  lines 
long,  and  usually  of  gray  substance.  This  olfactory  bulb  is,  in 
young  embryos  and  in  the  lower  animals,  hollow,  and  connected 
with  the  lateral  ventricles.  From  its  inferior  surface  many  deli- 
cate nn.  olfactorii,  covered  by  dura  mater ,  pass  downwards  through 
the  foramina  of  the  cribriform  plate  in  two  rows. 

The  external  row  (from  twelve  to  sixteen  nerves)  spreads  out 
in  a  rete  upon  the  mucous  membrane  of  the  two  superior  nasal 
conchae. 

The  internal  row  (from  nine  to  twelve  nerves)  expands  in  tufts 
upon  the  mucous  membrane  of  the  septum  of  the  nasal  cavity,  in 
the  centre  almost  to  its  floor. 

631.  II.  N.  opticus,  the  nerve  of  Sight. 

Origin:  from  ihalamus  opticus,  the  posterior  mass  of  which 
passes  into  the  optic  tracts,  corpp.  geniculata  and  quadrigemina. 
Course:  1.  As  tractus  opticus  (which  see).  2.  As  chiasma  n. 
optic,  (which  see).  3,  From  the  chiasma  the  n.  opticus,  even  now 
covered  by  the  dura  mater,  passes  forwards  and  outwards,  through 
foram.  opticum  into  the  orbit  and  to  the  globe  of  the  eye,  the  coats 
of  which  it  perforates  behind,  rather  internal  to  its  axis,  and  ex- 
pands as  the  retina  (which  see).  In  the  foram.  opticum  it  lies 
above  and  internal  to  art.  ophthalmica  ;  in  the  orbita,  surrounded 
by  the  four  mm.  recti,  and  much  fat ;  ganglion  ophthalm.,  nervi 
et  vasa  ciliares  lie  close  to  it.  Its  sheath  (of  the  dura  mater) 
passes  from  the  foramen  opticum  into  the  sclerotica.  It  nowhere 
divides  into  filaments,  but  has  in  its  centre  a  deficiency  (porus)  for 
the  vasa  centralia  iridis. 


382  SPECIAL  ANATOMY. 

632.  III.  N.  oculo-motorius,  the  nerve  of  Motion  for  the 

muscles  moving  the  globe  of  the  Eye. 

Origin :  between  the  crura  cerebri,  and  from  them,  with  a  series 
of  filaments,  the  most  internal  meeting  in  the  subst.  perforata  media 
(therefore  the  simultaneous  movement  of  both  pupils,  see  gangl. 
ophthalm.),  it  passes  forth  between  pans  Varolii  and  corpp.  mam- 
millaria.  Course:  at  the  commencement  flat,  between  art.  cerebri 
poster,  and  cerebelli  superior,  then  round  the  last  upwards,  out- 
wards and  forwards  as  far  as  sella  turcica,  where  it  perforates  the 
dura  mater  and  the  sinus  caver  nos.,  and  passes  at  the  most  inter- 
nal part  through  Jissura  orbitalis  superior  into  the  orbit.  Before 
that  it  divides  into  a  ram.  superior  and  inferior,  which  separate  in 
the  orbita  and  unite  (not  always)  with  plexus  caroticus.  Situation 
in  the  cavernous  sinus:  external  to  carotis,  above  n.  abducens,  in- 
ternal to  n.  patheticus  and  ophthalmicus ;  immediately  in  the 
orbits,  below  n.  frontalis  and  patheticus,  internal  to  ram.  nasalis. 

1.  Ramus  superior,  below  and  for  m.  rectus  super.,  and  for  lev. 
palpebr.  super.,  in  which  it  soon  ramifies  with  many  branches. 

2.  Ramus  inferior,  much  larger,  between  n.  opticus  and  abdu- 
cens,  internal  to  m.  red.  externus  /  it  immediately  divides  into 
three  branches : 

a.  Ram.  internus,  to  the  internal  surface  of  m.  red.  internus. 

b.  Ram.  inferior,  to  m.  red.  inferior. 

c.  Ram.  externus,  passes  on  the  outer  border  of  m.  rectus  infe- 
rior to  m.  obliq.  inferior,  and  gives  off  the  short  root  of  gangl. 
ciliare. 

N.  oculo-motor  is  the  motor  nerve  for  all  the  muscles  of  the 
globe  of  the  eye,  with  the  exception  of  m.  obliquus  superior  and 
rectus  externus. 

633.  IV.  N.  Trochlearis  s.  patheticus. 

Origin :  with  three  to  four  filaments  from  valvula  cerebelli  ante- 
rior s.  magna,  between  the  cerebrum  and  cerebellum,  behind  the 
corpp.  quadrigemm. ;  it  inclines  round  the  crus  cerebelli  super. 
and  appears  at  the  basis  before  the  pons  Varolii,  external  to  crus 
cerebelli,  internal  to  n.  trigeminus.  Course :  forwards  through  a 
canal  of  the  tentorium  to  the  outer  wall  of  the  sinus  cavernosus  ; 
passes  through  the  broadest  part  of  the  Jissura  orbit,  super.,  at  the 
same  time  with  ram.  frontalis,  into  the  orbits.  Here  it  passes  in- 
wards and  forwards,  obliquely  over  the  ram.  super,  n.  oculo-motor., 
and  the  posterior  extremity  of  mm.  levator.  and  rectus  sup.,  to  the 
superior  border  of  m.  obliquus  superior.  Situation  :  as  far  as  sella 


THE  NERVES.  383 

turcica,  between  pia  mater  and  arachnoid,  below  the  oculo-moto- 
rius  ;  in  the  sinus  cavernosus,  on  the  outer  side  of  the  last  nerve, 
above  n.  opkthalm.,  united  with  it  by  means  of  several  filaments  ; 
in  the  orbits,  close  under  the  periorbita,  internal  to  ram.frontalis, 
where  it  gives  off  filaments  to  the  ram.  lacrymalis.  Branches  : 
ram.  tentorii,  from  out  of  the  sinus  cavernosus  backwards  to  sin. 
transversus  ;  it  comes,  according  to  Arnold,  from  ophthalmicus. 

N.  trochlearis,  long  and  thin,  supplies  the  obliquus  superior,  is 
the  n.  respiratorius  oculi,  according  to  Sir  (X  Bell. 

634.  V.  N.  trigeminus  s.  quintus,  the  Tri facial  nerve. 

Origin  :  with  two  roots  ;  the  larger  posterior  (ganglion)  root, 
from  corp.  restiforme  (continuation  of  the  posterior  columns  of  the 
spinal  cord)  ;  the  anterior,  smaller  root  from  the  surface  of  the 
ponSj  in  the  anterior  lateral  part  of  which,  both  (the  small  root 
from  within)  become  visible  in  a  fissure,  as  they  are  united  into  a 
trunk.  Course  :  the  trunk  passes  from  the  pons  as  a  flat  fascicu- 
lus upwards,  outwards  and  forwards,  through  a  canal  which  the 
dura  mater  forms  with  the  superior  border  of  the  apex  of  the  pe- 
trous bone.  Here  the  fibres  of  the  posterior  root  (portio  major) 
separate  and  interlace,  and  form  alone  the  ganglion  Casseri, 
whilst  the  anterior  root  (portio  minor)  passes  away  under  the  pos- 
terior surface  of  the  ganglion,  and  with  the  third  branch  of  the 
ganglion  forms  the  n.  maxillaris  inferior.  [The  two  portions  of 
this  nerve  are  generally  separated  at  their  exit  from  pons  Varolii 
by  a  few  of  its  fibres.] 

Ganglion  Casseri,  the  semilunar  ganglion,  consists  of  soft  gray 
substance  traversed  by  white  fibres  ;  it  is  flat,  convex  in  front  and 
externally,  lies  on  the  anterior  surface  of  the  apex  of  the  petrous 
bone,  in  a  depression,  firmly  united  with  the  dura  mater.  The  three 
following  branches  pass  off  from  its  convexity  : 

Ramus  ophthalmicus. 

Ram.  maxillaris  superior ',  and 

Ram.  maxillaris  inferior. 

They  diverge  as  they  pass  out,  and  the  last  is  accompanied  by  the 
small  (motor)  root  of  the  n.  trigeminus.  From  the  Cass.  ganglion 
a  few  fibres  pass  to  the  tentorium  and  to  the  dura  mater  of  the 
petrous  and  sphenoid  bone  ;  others  to  the  phxus  caroticus. 

635.  Ramus  I.  trigemini  s.  N.  ophthalmicus, 

the  smallest  and  most  superior  of  the  three  branches  of  gangl. 
Casseri,  passes  forwards,  outwards  and  upwards,  on  the  outer  wall 


384  SPECIAL  ANATOMY. 

of  sinus  cavernosus,  gives  a  filament  backwards  which  accompa- 
nies another  of  the  trochlearis  to  the  tentorium,  and  divides  into 
three  branches,  which  pass  through  thejissura  orbitalis  superior, 
at  different  points,  into  the  orbita.  Position :  below  n.  trochlearis, 
external  to  n.  oculo-motorius  and  abducens.  Branches  from  with- 
out inwards  are :  N.  lacrymalis,  n.frontalis,  n.  nasalis. 

1.  N.  frontalis,  the  frontal  nerve,  the  continuation  of  ophthal- 
micus,  and  its  thickest  branch,  passes  horizontally  forwards  under 
the  periorbita  and  obliquely  above  the  lev .  palpebr .,  sends  frequent- 
ly a  small  branch  which  passes  over  the  m.  obliq.  sup,,  and  under 
the  trochlea,  out  of  the  orbita,  and  into  the  superior  eyelid.    In  front 
it  divides  into : 

a.  N.  supraorbitalis,  the  external  larger  branch,  which  passes 
through  foram.  supraorbitale,  out  of  the  orbita,  sends  nume- 
rous branches  downwards  to  the  superior  lids  (one  of  which 
anastomoses  with  n.facialis  beneath  n.  orbicularis),  two  others 
upwards  to  the  skin  of  the  forehead,  which  may  be  followed 
as  far  as  the  lambdoidal  suture,  but  only  supply  the  skin  and 
periosteum.     A  smaller  branch  passes  through  a  small  fora- 
men in  the  foram.  supraorbit.  into  a  canal  on  the  frontal  bone, 
and  to  the  skin  of  the  forehead  on  the  tuber  frontale. 

b.  N.  supratrochlearis,  the  smaller  internal  branch,  passes  out 
between  for.  supraorbit.  and  (above)  the  trochlea  of  m.  obliq. 
sup.,  and  divides  into  superior  branches  for  the  top  of  the 
forehead,  and  into  inferior  for  the  upper  lid  and  back  of  the 
nose,  where  it  anastomoses  with  n.  nasalis.     Sometimes  two 
nn.  supratrochl.  are  present. 

2.  N.  nasalis  s.  naso-ciliaris  passes  between  ram.  super,  and 
infer,  of  oculo-motor.,  inwards  and  forwards,  obliquely  over  n. 
opticus,  beneath  m.  rectus  and  obliq.  super,  to  the  internal  wall  of 
the  orbita,  and  divides  at  the  superior  border  of  m.  rectus  intern. 
into  n.  ethmoidalis  and  infratrochlearis.    Before  this  one  or  several 
nervi  ciliares  pass  off  from  it,  and  the 

a.  Radix  longa  ad  ganglion  ciliare,  a  minute,  sometimes  double 
filament,  which  separates  even  in  the  cranial  cavity  (in  the 
sinus  cavern.},  where  also  a  grayish  filament  (radix  media) 
from  plexus  carol,  n.  sympath.  is  applied,  and  accompanies  it 
to  the  posterior  angle  of  the 

Ganglion  ciliare  s.  ophthalmicum.  This  lenticular,  flat, 
grayish-red  ganglion  lies  in  a  considerable  quantity  of  fat 
on  the  outer  side  of  n.  opticus,  two  to  three  lines  distant 
from  the  optic  foramen,  beneath  art.  ophthalmica.  The 
radix  brevis  from  oculo-motorius  enters  at  its  posterior  in- 


THE  NERVES.  385 

ferior  angle.     From  its  anterior  border  two  small  fasciculi 
pass  off  the 

Nervi  ciliares.  They  pass  along  in  a  tortuous  manner 
with  artt.  ciliares,  anastomosing  with  one  another ;  they 
perforate  the  sckrotica  around  the  n.  opticus,  pass  evenly 
between  this  and  the  choroidea  to  the  ciliary  ligament,  and 
some,  thence,  to  the  iris,  where  they  divide ;  others  pass 
immediately  to  the  retina.  The  superior  fasciculus  has 
four,  the  inferior  five  to  six  filaments. 

b.  N.  eihmoidalis  passes  immediately  through  for  am.  ethmoidale 
anterius  from  the  orbit  into  the  cranial  cavity,  passes  from  be- 
hind forwards  upon  the  superior  surface  of  the  cribriform  plate 
of  the  ethmoid  bone  near  the  crista  gaUi,  and  sinks  into  the 
nasal  cavity  through  an  anterior  foramen,  where  it  divides  into 
an  internal  and  external  branch. 

1.  Ramus  interna  s.  septi  mobilis,  upon  the  mucous  mem- 
brane of  the  anterior  part  of  the  septum. 

2.  Ramus  externus  gives  a  branch  to  the  conchse  and  anterior 
part  of  the  septum  ;  passes  into  the  sulcus  of  the  nasal  bone, 
and  comes  forth  between  the  bones  and  cartilage,  and  rami- 
fies upon  the  skin  of  the  ala  nasi  as  far  as  the  point  where 
it  anastomoses  with  n.facialis. 

c.  N,  infratrochlearis  passes  on  under  m.  obliquus  superior  with 
art.  ophthalmica,  escapes  from  the  orbit  beneath  the  trochlea. 
and  divides  into : 

1 .  External  branches,  which  perforate  the  m.  orbicularis,  and 
at  the  free  border  of  the  superior  lid  anastomose  in  loops, 
supplying  the  lacrymal  sac  and  caruncle. 

2.  Internal  branches,  which  anastomose  upon  the  root  of  the 
nose  with  branches  of  n.facialis. 

3.  Superior  branches,  which  pass  to  the  forehead,  and  anasto- 
mose with  n.  supra-trochlearis. 

3.  N.  lacrymalis,  the  smallest  branch  of  ophthalmicus,  passes 
along  the  superior  border  of  m.  rectus  externus  on  the  outer  wall 
of  the  orbita,  with  art.  lacrymalis,  and  divides  into  an  external  and 
internal  branch. 

1.  Ramus  externus  s.  nerv.  zygomaticus  passes  through  the 
malar  bone,  uniting  with  n.facialis  on  the  cheek. 

2.  Ram.  internus  passes  through  the  lacrymal  gland,  ramifies 
in  it,  then   perforates  the  upper  lid  with  a  branch  which 
reaches  as  far  as  the  tarsus,  and  with  another  which  is  lost 
in  the  skin  of  the  anterior  temporal  region. 

25 


386  SPECIAL  ANATOMY. 

Ramus  II.  trigemini  s.  N.  maxillaris  superior. 

The  superior  maxillary  nerve,  in  point  of  size  and  position  in  the 
middle  between  /.  and  ///.,  passes,  after  a  short  course,  through 
foram.  rotundum  into  the  fossa  spheno-maxillaris,  where  branches 
pass  off  from  it  in  all  directions,  accompanied  by  branches  of  art. 
maxillaris  interna.  It  divides  (Arnold)  into  three  principal  branches, 
which  correspond  to  those  of  the  ophthalmicus. 

1.  N.  subcutaneus  males  corresponds  to  n.  lacrymalis,  enters 
the  orbita  through  Jlssura  orbital,  infer.,  passes  along  the  inferior 
wall  forwards,  and  divides  into  an  ascending  ram.  lacrymalis, 
which  enters  the  lacryrnal  gland  from  below,  anastomoses  with  n. 
lacrymal.,  and  gives  filaments  to  the  external  angle  of  the  eye; 
and  a  horizontal  ram.  malaris,  which  passes  along  through  the 
anterior  malar  foramen,  with  a  filament  for  the  skin  of  the  cheek, 
with  another  (often  double)  to  the  anterior  part  of  m.  temporalis, 
and  there  anastomoses  with  n.  tempor.  profund.     (See  maxillaris 
inferior.)     [A  temporal  branch  also  ascends,  perforates  the  outer 
wall  of  the  orbit,  afterwards  the  temporal  fascia,  and  supplies  the 
skin  about  the  external  angular  process  of  the  frontal  bone]. 

2.  N.  spheno-palatinus  corresponds  to  n.  nasalis,  a  shorter 
branch,  descends  vertically  into  the  fossa  spheno-palatina,  and  en- 
larges on  the  outer  side  of  the  foramen  into  the 

Ganglion  splwno-palatinum  s.  rhinicum  s.  Meckelii.  This 
grayish- red,  soft,  three  to  four-cornered  nasal  ganglion,  is 
larger  than  the  ophthalmic,  with  which  it  is  frequently  in  con- 
nexion by  means  of  a  filament  (Tiedemann).  It  consists  of 
two  roots  ;  the  short  consists  of  several  filaments  from  nerv. 
spheno-palatin.  ;  the  long,  radix  mollis,i\\at  is  ram.  profun- 
dus  n.  Vidiani,  comes  from  the  plexus  caroticus  n.  sympa- 
thici,is  grayish-red,  and  under  n.  Vidianus  recurrens  in  a 
sheath.  Two  or  three  filaments  pass  through  Jiss.  orbitalis 
infer,  into  the  n.  options.  Through  it  pass  : 
a.  Nn.  palatini,  descending  vertically.  They  are  : 

1.  Palatinus  anterius  s.  major,  passing  through  the  poste- 
rior palatine  canal,  at  the  inferior  orifice  of  which  it  in- 
clines forwards  upon  the  palatine  vault.  Before  that  it 
gives  off  ram.  nasalis  inferior,  for  the  middle  nasal  cham- 
ber and  the  inferior  concha ;  farther,  several  filaments, 
which  pass  upon  the  internal  walls  of  the  antrum  High- 
mori  to  the  last  molar  teeth  ;  lastly,  a  ram.  staphylinus 
for  the  uvula.  Its  terminal  branches  pass  on  the  alveolar 


THE  NERVES.  387 

borders  and  in  the  central  line  to  the  glands,  and  the  mu- 
cous membrane  of  the  palate,  and  to  the  gums. 

2.  Palatinus  posterior  s.  medius  passes  in  a  proper  canal, 
and,  having  left  it,  backwards  to  the  posterior  nasal  open- 
ing. 

3.  Palatinus  ezternus  s.  parvus,  for  the  palatine  arches  and 
tonsils. 

b.  Nn.  nasaks  posteriores,  very  fine,  pass  inwards  through  the 
for.  spheno-palatinum  into  the  nasal  cavity,  advancing,  when 
there,  between  the  bones  and  mucous  membrane  on  the  outer 
wall  and  on  the  septum.  They  pass,  contrary  to  the  branches 
of  the  first  division,  in  the  vault,  so  that  the  proper  nerves  of 
smell  are  surrounded  in  a  circular  manner  by  these  nerves  of 
sensation,  like  the  optic  nerve  by  the  nn.  ciliares. 

1.  N.  naso-palatinus  Scarpce  s.  n.  septi  narium  passes  in- 
wards, before  the  sinus  sphenoidalis,  below  its  opening  to 
the  nasal  septum,  and  on  this  almost  horizontally  forwards 
to  the  canalis  incisivus,  through  which  it  passes  to  the  mu- 
cous membrane  of  the  mouth  behind  the  incisor  teeth,  with- 
out anastomosing  with  that  of  the  other  side,  and  without 
forming  a  ganglion.  % 

2.  Nn.  nasales  superiores,  three  to  four,  pass  vertically  down- 
wards on  the  posterior  part  of  the  outer  wall  of  the  nasal 
cavity,  between  the  mucous  membrane  and  periosteum,  sup- 
plying the  concha  and  nasal  chambers,  and  the  pharynx 
at  the  orifice  of  the  tuba  Eustachii,  with  a  ram.  pharyn- 
geus  (Bock). 

3.  N.  Vidianus  s.  petrosus  superficial  s.  recurrens  passes 
from  the  posterior  part  of  ganglion  Meckelii  backwards, 
through  the  canalis  Vidianus,  enters  between  temporal  and 
sphenoid  bone,  perforating  the  mass  of  cartilage  in  theforam. 
lacerum  anter.,  into  the  cranial  cavity,  and  into  a  sulcus  on 
the  anterior  surface  of  the  petrous  bone,  through  hiatus 
canal.  Fallopice  to  the  bend  of  n.  facialis,  with  which  it 
anastomoses.     Below  it,  passes  the  n.  petrosus  prof  undus, 
a  larger  branch,  and  of  a  more  gray  hue,  which  lies  in  the 
can.  caroticus  on  the  outer  side  of  carotis,  and  ascends  ta 
the  gangl.  Meckelii  from  the  plexus  caroticus,  where  it 
anastomoses  with  the  branches  which  pass  to  the  nerv. 
oculo-motorius. 

3.  Nervus  infraorbitalis,  the  continuation  of  the  trunk,  corre- 
sponds to  the  n.frontalis,  enters  through  Jissura  orbital,  infer,  into 
the  canalis  infraorbitalis,  passes  to  its  anterior  orifice  (above  and 


388  SPECIAL  ANATOMY. 

external  to  art.  infraorbit.),  where  it  divides  into  fibres  on  the  face, 
and  sends  branches  upwards  : 

a.  Rami  palpebrales,  to  the  skin,  and  under  m.  orbicularis,  to 
the  conjunctiva  of  the  inferior  eyelid  ;  internally  : 

b.  Rami  nasales,  to  the  skin  of  the  alee,  nasi  ;  downwards  : 

c.  Rami  labiales,  to  the  upper  lip,  for  the  skin  and  mucous 
membrane.     These  last  are  very  numerous,  and  they  anasto- 
mose particularly  with  n.facialis. 

Before  its  entrance  into  the  canal,  infraorbitalis  the  trunk  gives 
off: 

1 .  N.  dentalis  posterior  superior  ;  it  often  arises  with  two  to 
three  filaments  (between  which  art.  alveolaris  poster.},  de- 
scends forwards  upon  the  tuber  maxillare,  gives  branches 
to  the  m.  buccinator  [they  most  likely  perforate  this,  and 
supply  the  mucous  membrane],  the  fat  of  the  cheek,  and 
the  gums.     The  superior  branch  penetrates,  above  tuber, 
maxillare,  the  inferior  below  it,  between  the  bony  plates 
of  the  upper  jaw,  into  the  canal,  alveolar,  poster,,  forms 
there  a  plexus,  from  which  one  filament  passes  off  for 
each  root  of  the  molar  teeth,  and  terminates  in  the  dental 
pulp. 

Inside  the  canalis  infraorbitalis  the  trunk  gives  off: 

2.  N.  dentalis  anterior  superior,  arising  half  an  inch  behind 
foram.  infraorbitale,  is  very  large;   it  passes  vertically 

down  in  a  canal  between  the  bony  plates  of  the  upper  jaw 
to  a  plane  with  the  floor  of  the  nose,  and  ramifies  close  to 
that  into : 

a.  Ascending  branches,  which  are  lost  in  spina  nasalis  anter., 
give  a  branch  to  the  nasal  mucous  membrane  and  inferior 
concha;  and : 

b.  Descending  branches,  for  the  -first  molar,  the  cuspidati, 
and  incisor  teeth. 

637.  Ramus  III.  n.  trigemini  s.  N.  maxillaris  inferior. 

The  inferior  maxillary  nerve  is  the  largest  and  most  posterior  of 
trigeminus,  consisting  of  a  posterior  external  fasciculus,  which 
comes  from  the  gangl.  Casseri,  and  an  anterior  internal  fascicu- 
lus, that  is,  the  small  root  (motor  fibres)  of  trigeminus.  Course : 
passes  quickly  out  of  the  cranial  cavity  through  foramen  ovaleinto 
the  fossa  zygomatica,  where  it  immediately  divides  into  eight 
branches,  of  which  the  three  first  belong  to  the  posterior,  the  five 
others  to  the  anterior  fasciculus. 


THE  NERVES.  389 

1.  N.  Umporal.  superficial,  s.  auricularis  anterior.  The  tem- 
poro-auricular  nerve  corresponds  to  the  lacrymalis  and  subcuta- 
neus  of  the  first  and  second  division.  Origin  :  outside  and  behind 
the  third  division,  with  two  roots,  which  surround  the  art.  menin- 
gea  media,  and  contain  two  filaments  of  gangl.  oticum.  Course : 
backwards  and  rather  downwards  behind  thecollum  condyli  of  the 
lower  jaw,  where  it  divides  into  an  ascending  and  descending 
branch. 

a.  Ram.  temporalis  inclines  backwards  and  upwards  around 
condylus,  between  the  articulation  and  external  auditory  mea- 
tus,  perforates  the  parotis,  and  passes,  in  company  with  art. 
temporal.,  into  the  temporal  region  close  beneath  the  skin,  in 
which  it  ramifies  to  the  vertex*     At  the  condyle  it  gives  one 
(important),  sometimes  two, 

ram.  communicantes  to  n.facialis,  farther  branches  to  the 
temporo-maxillary  articulation,  to  the  skin  of  the  meatus 
auditor,  extern.,  to  the  tympanic  membrane ;  in  the  tem- 
poral region  a  connecting  branch  with  n.  temporal,  pro- 
fund,,  and  a  plexus  for  art.  temporalis. 

b.  Ram.  auricularis  forms  a  plexus  behind  the  condylus  about 
the  art.  maxillar.  interna,  perforates  the  parotis  with  five  to 
six  branches  which  pass  to  the  lobe  of  the  ear  ;  others  anasto- 
mose with  filaments  of  plexus  cervicalis  ;  one  branch  unites 
with  n.  dentalis  ;  another  enters  the  maxillary  articulation. 

Ganglion  oticum  (Arnoldi).  This  flat,  oval  otic  ganglion 
is  situated  close  under  theforam.  ovale  on  the  inner  side  of 
n.  maxillar.  infer.,  where  the  portio  minor  trigemini  joins 
it  closely  ;  internal  to  the  cartilaginous  tuba  Eustachii  and 
the  origin  of  m.  circumflexus  palati  mollis,  before  art.  me- 
ningea  media.  It  has  three  roots  : 

1.  The  long  one  comes  from  n.  tympanicus  of  glosso-pha- 
ryngeus. 

2.  The  short  from  portio  minor  (especially  tfpterygoid.  in- 
ternus)  of  the  trigeminus. 

3.  The  central,  soft,  from  the  first  cervical  ganglion  of  sym- 
pathicus,  the  filaments  of  which  pass  along  the  art.  menin- 
gea  media.     From  it,  constantly,  arise,  from  the  upper 
portion  : 

1 .  Nerv.  ad  tensorem  tympani,  a  soft,  grayish-red  filament, 
passing  along  by  means  of  tuba  Eustachii  to  the  tensor 
of  the  tympanic  membrane.  Another  nerve  comes  from 
n.pterygoid.internus  to  this  muscle,  which  perforates 
the  otic  ganglion,  and  receives  a  little  of  its  substance ; 


390  SPECIAL  ANATOMY. 

on  this  account  the  memb.  tympani  cannot  be  directly 
moved  at  the  instigation  of  the  will.     Usually : 

2.  Two  filaments  to  n.  auricula  temporalis. 

3.  One  filament  to  the  chorda  tympani  (Krause),  and  one 
likewise  to  m.  circumfiexus  palati  mollis  (Cruveilhier). 

[The  translator  takes  the  liberty  of  adding,  in  this  place,  a  para- 
graph from  M.  Longet's  work  (Anat.  et  Phys.  du  Systeme  Nerveux, 
par  F.  A.  Longet,  2  vols.,  Paris,  1842),  vol.  ii.  p.  501 :-— "  As  for 
the  ganglia  which  constitute  the  cephalic  portion  of  the  great  sym- 
pathetic, I  have  myself  often  insisted  upon  the  double  connexion  of 
each  of  them  with  a  motor  and  sensitive  cerebral  nerve ;  and  I 
have  proved,  against  the  opinion  of  Arnold,  that  the  spheno-palatine 
ganglion  does  not  form  a  exception,  and  that  it  likewise  receives 
filaments  from  a  cranial  nerf  which  presides  over  movement.  All 
these  ganglia  (ophthalmic,  spheno-palatine,  otic,  and  sub-maxil- 
lary) having  been  described  with  details  suitable  to  the  trifacial 
nerve,  I  have  only  to  remind  the  reader  that  the  common  motor 
oculi  or  the  facial  nerve  furnishes  their  motor  roots,  whilst  the 
glosso-pharyngeal  or  the  trifacial  sends  to  each  of  them  the  sensi- 
tive roots."] 

2.  N.  alveolaris  inferior,  descends  at  first  between  m.pterygoid. 
extern,  and  internus,  then  between  internus  and  the  ramus  of  the 
lower  jaw,  separated  by  an  aponeurosis  from  n.  lingual  and  m. 
pteryg.  intern,  through  foram.  alveolare  poster,  in  the  canal,  alveo- 
laris in  the  same  sheath  with  art.  dental,  inferior.     From  this 
branches  are  given  off  to  each  root  of  the  inferior  molar  teeth.  As 
far  as  the  entrance  to  the  canal  the  ram.  mylo-hyoideus  accompa- 
nies it ;  in  the  canal  it  bifurcates  at  foram.  mentale  into  two  rami : 

a.  Ramus  dentalis  incisivus,  very  fine,  passes  farther  along 
the  canal,  and  supplies  the  cuspidati  and  incisor  teeth. 

b.  Ramus  mentalis,  stronger,  passes  out  at  the  foram.  mentale, 
ramifies  in  the  skin  and    mucous  membrane  of  the  under 
lip,  particularly  at  its  free  border,  and  forms,  with  n.facialis, 
a  plexus  mentalis. 

3.  N.  lingualis,  the  nerve  of  the  sense  of  touch  and  sensation 
of  the  tongue,  corresponds  to  n.  nasalis  and  palatinus  of  the  first 
and  second  division,  is  situated  farther  forwards  than  the  last, 
takes  a  curve  forwards  and  downwards,  at  first  between  m.  ptery- 
goideus  extern,  and  pharynx,  then  between  the  two  pterygoidei, 
pteryg.  internus  and  the  ramus  of  the  lower  jaw ;  thence  directly 
forwards  along  the  superior  border  of  the  sub-maxillary  gland, 
between  this  and  the  mucous  membrane  of  the  mouth,  above  m. 
mylo-hyoideus,  lastly  obliquely  beneath  the  sublingual  gland,  on 


THE  NERVES.  391 

its  internal  side  to  the  border  of  the  tongue,  and  between  m.  myfo- 
and  genio-glossus  into  the  substance  of  the  tongue ;  it  lies  above 
n.  hypoglossus,  and  terminates  in  tufts  upon  the  mucous  membrane 
and  the  papillae  at  the  borders  and  the  tip  of  the  tongue.  Between 
the  mm.  pterygoidei  it  receives  the  chorda  tympani,  which  blends 
with  it  behind  at  an  acute  angle ;  farther  a  connecting  branch 
from  n.  alveolaris  inferior.  It  gives  branches  to  the  tonsilla,  the 
mucous  membrane  of  the  cheeks,  and  the  gums  ;  from  its  inferior 
surface  filaments  pass  to  the  ganglion  linguale  ;  lastly,  also,  to 
the  gland,  sublingualis,  and  there  forms  a  pi.  sublingualis. 

Ganglion  glotticum  s.  linguale  s.  maxillare.  The  lingual 
ganglion  is  placed  in  the  curve  of  n.  lingualis  between  it  and  the 
gland  sub-maxittaris,  at  the  side  of  the  root  of  the  tongue,  oppo- 
site the  last  molar  tooth,  covered  by  the  mucous  membrane.  Its 
three  roots  are  received;  1.  from  the  chorda  tympani  of  n.  foci- 
alis  (motor) ;  2.  from  nerv.  lingualis  (sensitive) ;  3.  from  the 
first  cervical  ganglion  of  n.  sympathicus.  From  it  branches  pass 
off;  1.  to  the  ductus  Wkartonianus  (for  the  excretion  of  saliva 
in  the  act  of  tasting) ;  2.  to  the  n.  lingualis  (as  from  gangl.  oti- 
cum  to  the  auricularis  from  g.  ophtlialmicum  to  the  n.  opticus} 
of  hypoglossus. 

4.  Nervi  masticatorii,  the  three  branches,  contain  the  fibres  of 
the  portio  minor  n.  trigemini.  They  are  : 

1.  N.  mylo'hyoideus  passes  downwards  in  a  sheath,  with  nerv. 
alveolaris  inferior  as  far  as  foram.  alveolare  poster.,  then  in 
the  sulcm  mylo-hyoid.  of  the  lower  jaw,  and  ramifies  in  m. 
mylo-hyoideus,  and  the  anterior  belly  of  m.  biventer  (the 
posterior  belly  of  which  is  supplied  by  n.facialis). 

2.  N.  massetericus  inclines  backwards  and  over  incisura  semi- 
lunaris  outwards,  and  sinks  into  m.  masseter.     Above,  a 
deeper  branch  goes  to  the  temporal  fossa  and  to  the  maxillary 
articulation. 

3.  N.  temporalis  profundus,  frequently  double,  passes  upwards 
close  to  the  wall  of  the  temporal  fossae,  anastomosing  with 
branches  of  masseteric.,  buccinator. ,  and   temporalis  super- 

Jicialis  ;  with  lacrymalis  and  subcutaneus,  and  loses  itself 
in  the   muse,  temporalis. 

4.  JV.  buccinatorius,  a  larger  branch,  penetrates  the  m.  ptery- 
goid.  extern.,  gives  temporal  twigs,  passes  downwards  be- 
tween m.  pterygoid.  ext.  and  temporal.,  behind  proc.  coronoid. 
to  m.  buccinator,  anastomosing  behind  duct,  btenonianus  in 
a  curve  with  nerv.facialis,  and  giving  branches  to  the  muscles 
of  the  angles  of  the  mouth. 


392  SPECIAL  ANATOMY. 

5.  Nn.  pterygoidei  externus  and  internus  to  the  muscles  of  the 
same  name.  The  last  gives  filaments  to  m.  tensor  palati 
and  tympani  by  means  ofgangl.  oticum.  (Hence  the  mem- 
brana  tympani  is  stretched  by  the  pterygoid  muscles  in  loud 
sounds/&c.)  [?]. 

Distribution  of  the  Trigeminus  : 

a.  It  perforates  all  the  muscles  of  the  face  ; 

b.  Supplies  the  pterygoid  muscles  (with  motor  nerves)  ; 

c.  Supplies  the  skin  of  the  whole  face  ; 

d.  The  teeth,  gums,  and  jaws  ; 

e.  Enters  into  the  organs  of  smell,  sight,  hearing,  taste,  endow- 
ing them  with  common  feeling,  but  not  the  specific  sensation 
of  smell,  sight,  &c. ;  and  also  nutrition,  e.  g.  in  the  conjunc- 
tiva of  the  eyes. 

638.  VI.  N.  abducens,  the  nerve  for  the  external  rectus  muscle. 

Origin:  with  two  roots :  a.  from  the  posterior  border  of  pom 
Varolii  ;  b.  from  the  superior  part  of  corpus  pyramidale.  Course  : 
upwards  and  rather  outwards  from  under  the  pons,  perforates  the 
dura  mater,  and  passes  inwards  over  the  apex  of  the  petrous  bone 
into  the  cavernous  sinus.  Here  it  lies  on  the  outer  side  ofcarotis 
and  to  the  inside  of  the  veins  of  the  sinus,  and  receives  two 
branches-  from  plex.  caroticus  and  one  from  n.  ophthalmicus  ;  it 
then  passes  directly  forwards  through  the  fissura  orlitalis  supe- 
rior into  the  orbita,  [between  the  two  origins  of]  m.  rectus  exter- 
nus, lying  there  on  its  internal  surface  above  the  n.  oculo-moto- 
rius,  under  n.  ophthalmicus. 

639.  VII.  •N.facialis  s.  communicans  facwi, 

formerly  known  as  portio  dura  puris  VII.,  is  a  mixed  nerve, 
which  arises  with  two  roots  ;  the  larger  anterior  (motor)  root 
from  the  posterior  border  of  pons  Varol.,  in  the  fossa  between  this 
and  the  medulla  oblongata  ;  the  smaller  posterior  (sensitive),  from 
corpus  restiforme,  where  the  auditory  nerve  arises  (hence  the 
guidance  of  the  undulations  producing  sound  to  the  ear  by  means 
of  n.  facialis).  Course :  external  to  and  above  in  front  of  n. 
acusticus,  with  which  it  passes  along  to  the  meatus  auditorius 
internus. 

Pars  petrosa.  In  the  auditory  meatus  the  nerve  gives  a  small 
filament  to  n.  acusticus, — it  enters  the  canolis  Fallopii,  forms  at 
the  hiatus  c.  Fall,  a  curve — the  bend — around  the  cavity  of  the 


THE  NERVES.  393 

tympanum,  and  passes  out  through  theforam.  stylomastoideum  to 
the  face.  At  the  bend  the  small  root  forms  a  ganglionic  enlarge- 
ment, this  is  : 

ganglion  geniculatum,  a  grayish-red,  triangular  ganglion  which 
receives  the  n.  Vidian.  superfcial.  (of  nerv.  trigemin.)  and 
gives  off;  a.  some  minute  filaments  which  again  sink  back- 
wards into  the  auditory  nerve  with  a  reddish  enlargement ;  b.  a 
filament,  which  passes  to  the  long  root  of  gangl.  oticum.  Be- 
fore it  leaves  the  canal  the  n.facialis  gives  off: 

1.  Ram.  ad  fenestram  ovakm  going  along  through  a  small 
canal  in  the  posterior  part  of  the  fenestra  ovalis. 

2.  Nervus  stapedii,  passes  obliquely  inwards  to  the  muscular 
portion  of  m.  staped. 

3.  Chorda  tympani,  that  is,  a  nerve  which  runs  along  a  canal 
peculiar  to  it  (canal  chorda),  in  the  posterior  wall  of  the 
tympanum,  backwards  and  upwards,  then  forwards  in  the 
arch  through  the  cavity  of  the  tympanum,  free,  between  the 
long  crus  of  the  incus  and  the  manubrium  of  the  malleus, 
and   passing  forth  from  a    small   foramen  in   the  centre  of 

fissura  Glasseri,  it  applies  itself  to  n.  lingualis,  and  gives  a 
long  motor  root  to  the  ganglion  linguale. 

4.  Rami  communicantes  cum  n.  vago,  come  from  the  auricu- 
lar branch  of  n.  vagus,  two  small  branches. 

Having  made  its  exit  at  the  foram.  stylo-mast,  the  n.  facialis, 
whilst  situated  behind  the  parotis,  gives  off  the  following  branches : 

5.  N.  auriculo-occipitalis  s.  occipitalis  posterior,  inclines,  from 
the  stylo-mastoid  foramen  upwards,  and  divides  into  a  larger 
ram.  occipitalis,  which  ramifies  in  the  m.  occipit.,  the  perios- 
teum, and  on  the  vessels,  and  anastomoses  with  a  filament  of 
plex.  cervicalis  ;  and  into  a  ram.  auricularis,  which  supplies 
the  mm.  retrahentes  of  the  auricle  [and  the  other  muscles] 
and  anastomoses  with  the  rr.  temporales  of  n.  trigemini  and 
facialis  and  the  auricular  branch  of  n.  vagus. 

6.  N.  stylo- hyoideus  inclines  obliquely  outwards  to  the  m.  stylo- 
hyoid.,  and  anastomoses  with  the  n.  sympathicus  and  first 
cervical  nerve. 

7.  N.  digastricus  to  the  posterior  belly  of  m.  digastricus,  gives 
branches  to  the  carotis,  and  unites  with  n.  vagus,  trigeminus 
and  sympathicus. 

8.  Rami  parotidei  posteriores  come  partly  from   the   trunk, 
partly  from  the  branches,  and  terminate  in  the  substance  of 
the  parotis. 

After  this  the  trunk  curves  forwards  in  the  anterior  half  of  the 


394  SPECIAL  ANATOMY. 

parotid,  and  divides  into  three,  rarely  two,  diverging  branches, 
which  form  a  large  plexus  (plexus  parotideus  s.  anserinus)  which 
surrounds  the  art.  temporalis  with  a  posterior  loop.  From  this 
pass  into  the  face : 

1.  Nn.  zygomatici,  five  branches.     The  three  first  (also  tern- 
porales)  arise  close  under  the  auricle,  ascend  above  the  zygo- 
matic  process,  give  branches  to  the  auricle,  to  the  temple, 
mm.frontalis  and  orbicularis,  at'the  outer  angle  of  the  orbit, 
and  unite  with  one  another,  with  subcutan.  malce  and  tempo- 
ral, superficialis.     The  fourth,  frequently  a  branch  of  the 
third,  is  situated   more  deeply,  ramifying  below  in  the  m. 
orbicularis.     The  fifth  is  larger,  sends  a  superior  branch  to 
the  inferior  eyelid  to  the  n.  infraorbitalis  ;    an  inferior  to 
the  art.  auricular,  inferior  and  filaments  to  the  fat  below  the 
malar  bone. 

2.  Nn.  faciales  s.  buccales,  four  branches,  passing  over  m. 
masseter  forwards,   supplying   the    ductus  Stenonian.,   the 

,  vessels  and  muscles  of  the  face,  of  the  inferior  part  of  the 
forehead,  of  the  nose,  of  the  lower  eyelid  downwards  as 
far  as  risorius  Santorini.  They  anastomose  with  n.  infra* 
orbitalis  and  its  plexus. 

3.  N.  marginalis  maxillce  inferioris  s.  labio-mentalis,  descends 
to  the  angle  of  the  lower  jaw,  bends  forwards  and  passes 
over  the  horizontal  ramus  of  the  lower  jaw  with  a  superior 
branch  for  the  upper  portion  of  the  lower  lip,  with  an  infe- 
rior branch  to  the  chin  joining  the  plexus  mentalis  of  n. 
mentalis  (see  trigemin.) 

4.  Nervi    ad   plexum   platysmamyoideum,    generally    three 
branches,  descend  on  the  vertical  ramus  of  the  lower  jaw 
to    the   m.  platysmamyoides   anastomosing    with   the    last 
nerve  and  the  third  cervical ;    they  reach  to  the  region  of 
the  larynx. 

640.  VIII.  Nervus  acusticus,  the  nerve  of  Hearing, 
formerly  portio  mottis  paris  VII.,  arises:  1.  In  the  rhomboidal 
fossa,  behind  n.  facialis,  from  corp.  restiforme  ;  2.  From  crus 
cerebelli  superius,  around  which  it  bends ;  coming  forth  behind 
the  pons  and  passing  on  the  outer  side  of  n.  facialis,  which  it 
receives  in  a  groove,  outwards  and  upwards  to  the  internal  audi- 
tory meatus.  Here  it  unites  by  means  of  filaments  with  the  n. 
facialis  ;  and  divides  into  an  anterior  (n.  cochlea)  and  a  posterior 
(n.  vestibuli)  principal  branch  which  pass  through  the  foramina 
in  the  base  of  the  auditory  meatus  to  the  labyrinth. 


THE  NERVES.  395 

1.  -ZV.  cochlea,  passes  through  the  anterior  foramen  with  spirally- 
arranged  fibres,  becoming  the  more  so  as  they  approach  themodiolus, 
sending  its  branches  through  the  tractus  spiralis  foraminulentus, 
which  form  loops  upon  the  lamina  spiralis,  and  terminate  at  the 
infundibulum. 

2.  2V.  vestibuli,  passes  backwards  and  divides  into  three  branches 
which  go  through  three  fossae  to  the  vestibule.     A  grayish-red  en- 
largement is  found  on  it,  like  the  auditory  nerve  which  is  generally 
rather  reddish. 

a.  2V".  saccularis  major,  passes  obliquely  forwards  to  the  superior 
fossa  and  its  canaliculi  into  the  saccus  oblongus  and  the  ampulla 
of  the  superior  and  external  semicircular  canals. 

b.  2V.  saccularis  'minor,  more  horizontal  to  the  saccus  hemi- 
sphericus. 

c.  2V.  amputtaris  inferior,  deeper,  through  the  external  fossa  to 
the  ampulla  of  the  posterior  semicircular  canal. 

641.  IX.  2V.  glosso-pharyngeus. 

Origin  :  with  a  series  of  filaments  (two  roots)  from  corp.  resti- 
forrne,  above  n.  vagus,  below  n.facialis;  passing  out  between  corp. 
restiforme  and  olivare.  Course :  the  trunk  passes,  a  distance  of  from 
one  half  to  three  quarters  of  an  inch  outwards,  forwards  and  rather 
upwards  to  the  anterior  part  offoram.  jugulare,  separated  from  the 
n.  vagus  by  a  vessel,  forms  two  ganglia,  passes  out  from  the  cranial 
cavity,  and  divides  into  two  branches.  Situation :  in  Iheforam. 
jugulare ;  in  front  and  above,  before  n.  vagus  and  accessorius, 
before  and  on  the  inner  side  of  v.jugularis  interna,  in  a  canal  of 
dura  mater  ;  below  the  foramen  :  united  with  a  ramus  of  n.  sym- 
pathicus,  curved  forwards  and  downwards  on  the  outer  surface  of 
carotis  interna,  on  the  internal  of  m.  stylo-pharyngeuj,  removed 
from  v.jugularis  int.,  n.  accessorius  and  vagus.  Junctions :  with 
n.  vagus,  its  auricular  and  pharyngeal  branch  with  plexus  caroticus; 
and  with  n.facialis  in  the  m.  digastricus. 

1.  Ganglion  jugulare  (Ehrenritter,  J.  Miiller),  lies  (from  a  half 
to  one  line  long  and  broad)  upon  the  posterior  fasciculus  of  glosso- 
pharyngeus,  the  anterior  and  posterior  roots  of  which  unite  above 
and  below  it,  in  the  superior  part  of  the  foram.  jugulare.     Below 
it  (from  two  to  four  lines)  lies  a  larger  ganglion. 

2.  Ganglion  petrosum  (Andersch).     It  is  oval,  one  and  a  half 
to  two  lines  long,  situated  in  the  vettecula  of  the  petrous  bone,  and 
receives  on  its  superior  and  anterior  part : 

Nerv.  tympanicus  s.  Jacobsonii.     The  tympanic  nerve  ascends 
by  means  of  a  peculiar  canal  (upon  the  crest  between  canal  caro- 


396  SPECIAL  ANATOMY. 

ticus  and  fossa  jugularis)  to  the  inner  wall  of  the  tympanum,  is 
surrounded  by  a  thin  ganglionic  mass  (ganglwlum  tympan.) 
receives  a  filament  from  pkx.  caroticus,  and  gives  a  branch  to 
thefenestrce  rotund,  and  ovalis.  Below  the  last  the  trunk  bends 
round,  forwards  and  downwards,  passes  through  tuba  Eustachii, 
perforates  its  cartilage,  and  terminates  in  the  glands  about  its 
orifice.  Two  branches,  besides,  pass  off  on  a  plane  with  the 
fenestra  ovalis. 

a.  TV.  petrosus  profundus  minor,  passes  through  a  canal  of  the 
septum  between  tuba  Eustachii  and  canal,  caroticus  in  the 
last  "to  the  plex.  carotic.,  where  it  unites  with  ram.  prof.  n. 
Vidian. 

b.  Ram.  communicans  n.  petrosi-superficialis  minoris,  passes 
in  a  canal,  behind  the  tubce  Eustachii  upon  the  anterior  sur- 
face of  the  petrous  bone  to  n.  petros.  superf.  minor  (see 
nerv.facialis),  which  passes  through  foram.  spinos.  to  gangl. 
oticum. 

(Plexus  tympanicus  major,  Jacobson's  anastomosis  is  princi- 
pally formed  by  a.,  lies  upon  the  internal  wall  of  the  tympanum, 
supplies  the  mucous  membrane  and  osseous  substance,  and  is 
probably  in  connexion  with  the  chorda  tympani.) 

3.  Ramus  pharyngeus,  divides  into  from  two  to  three  branches, 
which  form,  with  those  of  n.  vagus,  the  pkx.  pharyngeus,  and 
supply  m.  constrictor  super,  and  med.  and  the  posterior  part  of 
the  pharynx. 

4.  Ramus  lingualis,  the  nerve  of  taste,  the  continuation  of  the 
trunk,  passes  in  a  curve,  convex  behind,  from  the  carotis  interna 
to  the  root  of  the  tongue,  giving,  in  this  course,  branches  to  m. 
stylo-pharyngeus,  which  lies  before  it,  to  the  tonsils  above,  to  the 
mucous  membrane  of  the  root  of  the  tongue,  where  it  anastomoses 
with  n.  maxillaris  inferior.     In  the  root  of  the  tongue  it  divides 
immediately  into  an  external  branch  for  the  mucous  membrane  of 
the  border  and  the  inferior  surface,  and  an  internal  branch  for  the 
posterior  third  of  the  mucous  membrane,  as  it  forms  a  plexus  about 
the  foramen  ccecum.     Both  unite  with  n.  maxillar.  inferior  and 
trigemini, 

642.     X.  IV.  Vagus  s.  pneumogastricus,  the  Vagus  nerve. 

Origin  :  with  from  twelve  to  sixteen  filaments  (united  into  from 
six  to  eight  fasciculi)  from  the  central  columns  of  medulla  oblong. 
between  corp.  olivare  and  restiforme.  Course :  under  the  cere- 
bellum obliquely  downwards,  forwards  and  outwards  to  the  ante- 
rior part  of  the  foram.  jugulare.  It  here  lies  in  an  especial  sheath 


THE  NERVES.  397 


(of  dura  mater}  behind  nerv.  glosso-pharyng. ;  before  v. 
interna ;  it  forms  a  ganglion  to  which  nerv.  accessor.  WiUisii  is 
applied.  Below  the  foram.  jugulare  it  forms  a  plexus  ganglia- 
form.;  is  placed  at  first  before,  then  on  the  inner  side  ofven.jugu- 
laris,  n.  accessor,  and  hypoglossus;  it  passes  downwards  along  the 
neck  behind  carotis  (within)  and  jugularis  (without),  in  one  sheath 
with  them,  separated  from  n.  sympathicus  (which  is  behind  and 
outside)  by  uniting  tissue,  to  the  thorax,  and  from  this  with  the 
oesophagus  through  the  diaphragm,  where  it  terminates  in  the 
plexus  Solaris  on  the  stomach. 

643.  (I.)  The  cranial  portion. 

a.  Ganglion,  jugulare  n.  vagi,  lies,  almost  enclosed  in  dura 
mater,  in  the  superior  part  of  the  for.  jugulare,  oval,  flat,  and 
two  lines  long,  receives  a  few  filaments  from  n.  accessorius, 
glosso-pharyng.,  sympathicus  and  facialis.     From  its  ante- 
rior external  side  arises : 

1.  N.  auricularis.     The  auricular  branch  passes  round  the 
bulbus  v.  jugul.  forwards,  gives  a  filament  to  n.  Jacobsonii, 
passes  through  a   canal  behind  proc.  styloideus  into  the 
canal.  Fallopiee,  here  anastomoses  with  n.  facialis,  passes 
through  a  canal  in  the  proc.  mastoid.  again  outwards  to 
the  skin  of  the   posterior  part  of  the  external  auditory 
meatus.     (Important  on  account  of  the  sympathy  existing 
between  the  Ear,  Lungs,  and  Stomach. — ARNOLD.) 

2.  Connecting  twigs  with  the  gangl.  cervicale  I.     (See  this.) 

644.  (II.)  The  cervical  portion. 

b.  Plexus  ganglioformis  s.  nodosus,  lies  half  an  inch  below  the 
foram.  jugulare,  and  is  a  loose  plexus  of  the  fasciculi  of  the 
vagus,  the  meshes  of  which  are  filled  with  a  grayish-red  fat. 
It  unites  with  nerv.  hypoglossus,  glosso-pharyng.  and  sympa- 
thicus, sometimes  also  with  the  first  cervical  nerves.     From 
it  arise  : 

1 .  Nn.  pharyngei.  The  superior  pharyngeal  nerve  unites 
with  n.  hypoglossus,  passes  to  m.  constrictor  super.,  and 
the  mucous  membrane.  The  delicate  middle  unites  with 
n.  pharyngeus,  the  glosso-pharyng.,  and  passes  with  these 
also  to  the  superior  part  of  the  pharynx.  The  inferior 
descend  obliquely,  unite  with  n.  sympathicus,  and  termi- 
nate in  m.  constrictor  medius  and  crico-pharyngeus. 
They  form : 


398  SPECIAL  ANATOMY. 

Plexus  pharyngeus,  lying  on  the  lateral  walls  of  the 
pharynx,  entwining  around  the  art.pharyng.  ascendens, 
and  terminating  in  the  muscles  and  the  mucous  membrane. 
At  the  superior  part  fibres  generally  come  from  glossophar., 
in  the  middle  from  n.  vagus,  below  from  vagus  and  sym- 
patkicus. 

2.  N.laryngeus  superior.  The  superior  laryngeal  nerve  (prin- 
cipally a  sensitive  nerve)  arises  on  the  inner  side,  and  passes 
along  it  close  to  the  pharynx,  obliquely  behind  the  carotis 
interna  forwards  and  inwards,  and  divides  into : 

1.  2V.  laryngeus  externus,  the  smaller   inferior   branch   arising 
sometimes  from  the  trunk  of  the  vagus  itself,  passes  downwards 
and  inwards,  and  at  the  side  of  the  larynx  forwards,  between 
m.  constrictor  infer,  and  thyroid,  cartilage,  and  is  lost  in  the 
m.   crico-thyreoideus   and   upon   the   internal   surface   of   the 
larynx — in  the  m.  crico-arytcenoid.     It  receives  two  filaments 
of  sympathetic,  and  gives  some  to  n.  cardiacus  behind  carotis 

.  interna  (this  is,  plex.  laryngeus) ;    farther,  to  m.  constrictor 
infer,  and  thyroid,  gland. 

2.  2V.    laryngeus  internus,   continuation   of  the   trunk,   passes 
between  os.  hyoid.  and  larynx,  enters  into  the  last  with  art. 
laryngea  super.,  and   divides  beneath  the  mucous  membrane 
in  a  radiating  form  into  anterior  and  posterior  branches.     It 
supplies  the  mucous    membrane  of  the  epiglottis,  the  thyroid 
cartilage,  membr.  hyo-thyreoid.,  of  the  vocal  cords,  of  the  mm. 
arytcenoidei  [merely  perforating   them  in  order  to  reach   the 
mucous  membrane],  and  anastomoses  upon  the  posterior  sur- 
face of  the  cricoid  cartilage  with  nerv.  recurrens. 

c.  Several  vascular  branches  pass  over  and  under  the  point  of  bi- 
furcation of  carotis,  forming  plexuses  about  these  vessels. 

d.  Rami  cardiaci,  from  two  to  four,  arise  below  the  region  of  the 
point  of  bifurcation  of  the  carotis,  pass  downwards   upon  it, 
anastomosing  with  one  another,  and   passing  into  the  plexus 
cardiacus  (of  sympathicus).     To  these  also  belongs  the  ram. 
descendens,  which  passes  from  the  posterior  part  of  the  vagus,  in 
the  inferior  part  of  the  neck  above  the  carotis,  partly  to  the 
cardiac  plexus,  partly  to  the  oesophagus,  and  anastomoses  with 
n.  sympathicus. 

645.         (III.)  The  thoracic  portion  of  the  Vagus. 

Upon  the  right  side  of  the  trunk  passes  between  ven.  and  art. 
subclavia  ;  upon  the  left,  between  carotis  communis  and  art.  sub- 


THE  NERVES.  399 

clavia  into  the  chest.  Course  as  far  as  the  roots  of  the  lungs ;  upon 
the  rigid  side :  behind  v.  anonyma  and  cava  super.,  in  the  sulcus 
between  trachea  and  oesophagus  downwards  to  a  point  behind  the 
roots  of  the  lung;  upon  the  left:  behind  v.  anonyma  to  the  left  of 
arcus  aorta  and  behind  bronchus  sinister.  Hence  it  passes  into 
the  cavum  mediastin.  postic.,  divided  into  two  branches,  upon  the 
right  side,  behind,  upon  the  left,  before,  the  oesophagus,  through 
the  foramen  cesophageum  into  the  abdomen.  Branches  : 

1.  Nerv.  recurrens  s.  laryngeus  inferior,  arises  upon  the  right 
side  (where  it  is  frequently  double)  before  the  art.  subclavia,  upon 
the  left,  before  the  arcus  aorta,  externally  to  the  ductus  Botatti, 
at  the  place  where  the  vagus  passes  backwards ;  it  bends  itself 
under  the  vessels,  and  passes  upwards  behind  them  on  the  outer 
side  between   tracJiea  and  oesophagus,  perforates  m.  constrictor 
pharyngeus  infer.,  and  enters  the  larynx ;  terminating  in  the  m. 
crico-arytanoideus  [and  m.  arytanaidei~\.     It  gives  branches  to 
the  mucous  membrane  [7]  and  to  the  muscles  as  well  to  the  con- 
strictors as  to  the  dilators  of  the  larynx ;  also  to  the  ozsopliagus 
and  the  trachea  [the  muscular  fibres  behind]  ;  anastomosing  with 
n.  laryngeus  super,  and  n.  sympathicus  by  means  of  some  rami 
cardiaci.     It  is  principally  a  motor  nerve. 

2.  Rami  cardiaci  thoracici,  are  from  five  to  six  larger,  and 
several  more  delicate  branches,  which  pass  into   the  following 
plexus,  or  are  lost  upon  the  external  surface  of  the  pericardium. 

Plexus  cardiaci,  formed  of  vagus  and  sympathicus,  entwine 
about  the  great  vessels  of  the  heart,  and  are  separated  at  the 
point  of  reflection  of  the  pericardium  into  superior  and  in- 
ferior, but  connected  with  each  other  as  well  as  with  those  of 
the  oesophagus  and  trachea. 

3.  Rami  tracheales  inferiores,  lie  on  the  anterior  surface,  close 
above  the  bifurcation  of  the  trachea,  intermingling  at  this  point 
with  nerv.  sympathicus  into  a 

Plexus  trachealis  anterior,  which  is  connected  with  the  internal 
cardiac  plexus,  and  proceeds  into  the  plex.  pulmonalis  an- 
terior, which  covers  the  bronchi  in  front. 

On  the  posterior  surface  of  the  trachea,  a  plexus  tr.  posterior 
also  arises,  from  six  to  seven  branches,  which  is  connected  with 
the  pharyngeal  and  cardiac  plexus,  and  gives  branches  to  the 
mucous  membrane  of  the  bronchi. 

4.  Plexus  pulmonalis  posterior,   frequently   arises   from  the 
trunk  of  the  vagus ;  from  four  to  six  branches,  upon  the  right 
and  left  side  of  the  lungs.     The  left   is  the    larger.     Both  are 
connected  together  with  plex.  trachealis,  and  enter  the  lungs  with 


400  SPECIAL  ANATOMY. 

the  bronchi.  Some  filaments  are  lost  in  the  pulmonary  artery. 
Its  posterior  filaments  belong  to  n.  sympathicus,  from  its  three 
superior  ganglia. 

5.  Plexus  oRsophageus  inferior,  formed  by  the  internal  principal 
trunk  of  the  vagus,  which  descends  farther  on  the  O3sophagus  be- 
low the  bronchi,  entwines  around  it,  and  penetrates  between  its 
coats.  The  right  vagus  passes  more  towards  the  posterior  (pi. 
Q3soph.  post.) -,  the  left  more  towards  the  anterior  surface  (pi.  an- 
terior). Both  anastomose  with  each  other  by  large  branches. 

646.  (IV.)  The  abdominal  portion  of  the  Vagus. 

The  right  trunk  enters  behind,  the  left  before  the  ossophagus, 
through  the  foram.  c&sophageum.  Each  is  lost  in  a  fasciculus, 
rami  gastrici,  and  forms  a  plexus  gastricus. 

1.  Plex.  gastricus  anterior,  formed  by  the  left  n.  vagus,  lies 
upon  the  anterior  surface  along  the  small  curvature  from  the 
Cardia  to  the  Pylorus ;  gives  branches  to  the  fundus  ventri- 
culi ;    to   the   small   omentum   as   far   as  fossa   transversa 
hepatis. 

2.  Plexus  gastricus  posterior,  formed  by  the  right  n.  vagus, 
lies   behind  the  cardia,  is  smaller  than  1,  and  passes,  princi- 
pally, into  tine  plex.  Solaris. 

Connexions  of  the  n.  vagus :  with  n.  trigeminus,  facialis, 
glosso-pharyngeus,  accessorius  Willis.,  hypoglossus,  cervicaU.  su- 
perr.  3,  and  sympathicus. 

Function.  The  vagus  is  entirely  sensitive  until  its  connexion 
with  n.  accessor.  Willis.,  then  a  motor  nerve  likewise. 

647.  XI.  N.  accessorius  Willisii,  the  spinal  accessory  Nerve. 

Origin :  from  the  posterior  part  of  the  central  columns  of  the 
spinal  cord,  between  the  posterior  roots  of  the  fourth  to  the  sixth 
cervical  nerves  (sometimes  even  deeper)  and  lig.  denticulatum  ; 
with  six  to  seven  radical  filaments,  which  are  strengthened  by  the 
posterior  roots  of  the  first  (to  the  third)  cervical  nerves,  but  only 
pass  in  a  sheath  with  them,  and  often  present  a  small  ganglion, 
but  which  belongs  to  the  cervical  nerves.  Course  :  upwards  on 
the  sides  of  the  spinal  marrow,  always  becoming  more  distant 
from  it ;  over  the  first  cervical  nerve,  strengthened  by  some  fila- 
ments, through  the  foram.  magnum  to  the  cranial  cavity.  It 
here  passes  in  a  curve  downwards,  forwards,  and  outwards,  en- 
veloped by  the  dura  mater,  to  the  vagus,  passes  into  its  sheath, 
on  the  outer  side,  and  behind  it,  through  foram.  jugulare,  pass- 


THE  NERVES.  401 

ing  on  it  and  its  ganglion,  and  dividing  into  its  two  branches. 
It  is  a  motor  nerve,  and  holds  the  same  relation  to  the  vagus 
as  the  posterior  root  of  a  spinal  nerve  does  to  the  anterior. 

1.  Ram.  internus,  passes    downwards,  partly  into  the  nerv. 
pharyng.  superior,  partly  through   the   plex.  ganglioform 
(probably  into  the  laryng.  superior,  and)  into  the  thorax,  to 
the  nerv.  recurrens,  the  pharyngeal  and  gastric  plexus. 

2.  Ram.  externus,  the  posterior  branch,  the  continuation  of  the 
trunk,  descends  behind  ven.  jugular,  interna  outwards  and 
backwards,  perforates  m.  sternockidomast.  at  the  superior 
third,  gives  branches  to  it,  becomes  enlarged  by  means  of 
branches   from  the  second    and    third  cervical  nerves,   and 
enters  the  m.  trapezius  on  the  internal  surface,  ramifying  in  it 
as  far  downwards  as  its  inferior  extremity. 

648.       XII.  Nerv.  Hypoglossus,  the  lingual  Nerve. 

Origin  :  between  carp,  pyramidale  and  olivare,  with  ten  to  fif- 
teen filaments,  which  unite  into  two  fasciculi,  in  a  row  with  the 
anterior  roots  of  the  spinal  nerves,  behind  the  art.  vertebralis. 
Course  :  the  two  fasciculi,  covered  by  the  pia  mater,  perforate  the 
dura  mater  separately,  become  covered  by  it,  and  ascend  to  the 
foram.  condyloid.  anterius,  through  which  the  united  trunk  passes 
out  of  the  cranial  cavity  (one  line  thick).  Hence  it  passes  down- 
wards and  forwards,  situated  internal  to  and  behind  n.  accessorius, 
vagus,  and  v.jugularis  interna  ;  inclining  in  a  curve  from  above, 
behind  and  internally  over  vagus  and  carotis  (over  the  place  of 
bifurcation)  forwards,  upwards,  and  inwards,  to  the  tongue.  Here 
it  is  situated,  at  first,  internal  to  and  under  m.  digastricus,  then, 
above  art.  thyreoid.  and  lingualis,  external  to  them,  internal  to 
m.  stylo-glossus.  Finally,  it  passes  upwards  and  forwards  into 
the  flesh  at  the  inferior  surface  of  the  tongue,  covered  by  gland, 
submaxillaris  and  m.  mylo-hyoideus,  where  it  terminates  at  the 
apex. 

Connecting  branches  with  :  the  first  cervical  ganglion  of  the 
sympathetic,  and  the  first  and  second  cervical  nerves,  n.  vagus, 
n.  lingualis  trigemini.  Vascular  branches  :  to  carotis  andjitgu- 
laris  interna  and  art.  lingualis.  Muscular  branches  for :  hyo- 
thyreoid.,  genio-hyoideus,  hyo-,  stylo-,  genio-glossus,  and  gland, 
submaxillaris.  Finally  : 

Ram.  descend.  Iwjpoglossi,  arises  from  the  commencement  of 

the  curve,  descends  outside  the  carotis   before  the  vagus  (in 

the   same   sheath),  anastomoses  with  it,  the  third  cervical 

nerves  [sometimes   the   second  or   even   the  fourth],  gives 

26 


402  '   SPECIAL  ANATOMY. 

branches  to  m.  omo-hyoideus  [and  a  long  filament  for  the 
posterior  belly],  sterno-,  hyo-,  and  thyreoideus,  and  passes 
behind  the  last  to  the  plex.  cardiac,  super.,  and  with  another 
branch  to  the  nerv.  pkrenicus  in  the  mediastin.  anticum. 
Nerv.  hypoglossus  is  a  motor  nerve  only. 

649.  The  Spinal  Nerves,  Nervi  spinales. 

From  thirty-one  to  thirty-two  pairs  are  enumerated,  namely  : 
eight  cervical,  twelve  dorsal,  five  lumbar,  five  sacral,  and  one  to 
two  coccygeal  pairs  of  nerves. 

They  arise  with  two  roots  from  the  sides  of  the  anterior  and 
posterior  columns  of  the  medulla  spinalis,  connected  with  the 
gray  matter  in  the  interior. 

The  anterior  (motor)  root  is  smaller  than  the  posterior,  separated 
from  it  by  means  of  the  ligam.  denticulatum,  and  arises  from  a 
narrow  white  line.  The  posterior  (sensitive)  root  is  stronger, 
arises  from  the  gray  lateral  sulcus,  and  is  provided  with  a  gan- 
glion (ganglion  spinale). 

Course.  Both  roots,  enveloped  in  arachnoid,  approach  each 
other,  without  anastomosing,  and  pass  out,  even  still  surrounded 
by  a  sheath  of  the  dura  mater,  through  a  corresponding  interver- 
tebral  foramen.  The  superior  spinal  nerves  pass  off  horizontally, 
and  are  shorter,  the  inferior  at  so  much  the  more  of  an  acute 
angle  with  the  spinal  cord,  the  nearer  they  approach  its  termina- 
tion. The  two  roots  unite  into  one  trunk  after  their  exit  from  the 
intervertebral  foramen,  which  immediately  divides  into  an  anterior 
and  posterior,  and  branches  for  the  n.  sympathicus.  Fibres  from 
the  anterior  as  well  as  from  posterior  roots  are  united  in  these 
branches. 

a.  Ganglia  spinalia,  reddish,  firm  ganglia,  formed  by  the  pos- 
terior roots  of  the  spinal  nerves,  are  situated  one  in  each  interver- 
tebral foramen  ;   but   those  of  the  sacral  and  coccygeal  nerves, 
while  still  within  the  canalis  spinalis  and  the  dura  mater.     They 
are  so  much  the  larger,  the  stronger  their  roots  and  the  branches 
passing  off.     The  anterior  roots  of  the  spinal   nerves  are  merely 
applied  to  their  anterior  surfaces  (according  to  Cruveilhier  they 
are  also  united  to  them  by  fibres). 

b.  The  anterior  branches  of  the  spinal   nerves  are,  with  the 
exception  of  the  first  and  second  cervical,  much  stronger  than  the 
posterior,  flat,  and  pass  forwards  and  outwards  before  the  trans- 
verse processes.     In  the   neck,  the  loins,  and  sacrum,  they  form 
loops  by  means  of  ascending  and  descending  branches,  in  conse- 
quence of  which  a  plexus  arises,  from  which   the  nerves  pass  off 


THE  NERVES.  403 

to  the  extremities,  in  particular.  In  the  back  (nn.  intercostales) 
they  pass  singly,  without  forming  a  plexus. 

c.  The  posterior  branches,  much  smaller  than  the  anterior,  pass 
between  the  transverse  processes  (foram.  intervertebrr.  posterr. 
Cruveilhier),  and  through  the  foram.  sacralia  postt.  backwards, 
divide  into  several  branches,  and  soon  terminate  in  the  muscles 
and  the  skin  of  the  back  from  the  occiput  to  the  coccyx. 

650.  1.  The  cervical  nerves,  Nervi  cervicales  (eight  pairs). 

Their  posterior  branches  pass  at  first  transversely  inwards  be- 
tween m.  complexus  and  semispinalis,  perforate  the  trapezius  from 
before  backwards,  and  take  a  retrograde  course  beneath  the  skin 
transversely  outwards  ;  they  also  unite  with  the  plexus.  Those  of 
the  two  first  are  larger  than  the  anterior.  The  anterior  branches 
form,  principally,  the  plexus  cervicalis  brachialis. 

651.  a.  The  four  superior  cervical  nerves 

supply  the  skin  and  muscles  of  the  occiput,  nape  of  the  neck  and 
cervical  region,  and  form  the  plex.  cervicalis,  from  which  n.  phre- 
nicus  arises. 

1.  Nerv.  cervicalis  1.  s.  infra  occipitalis  Aschii,  one  of  the 
smallest  spinal  nerves,  passes  forth  under  art.  vertebralis  (rarely 
over  it)  between  occiput  and  atlas,  behind  proc.  obliquus,  and  di- 
vides below  the  curvature  of  the  art.  vertebralis.  Its  larger  ante- 
rior root  contains  from  three  to  four  fasciculi,  the  smaller  posterior 
from  two  to  three.  It  is  situated  farther  forwards  than  the  rest  of 
the  posterior  roots,  applies  itself  to  the  n.  accessories ,  and  is  said 
to  be  sometimes  wanting.  Its  ganglion  lies  in  the  foram.  inverte- 
brale. 

a.  Rambus  anterior,  passes  on  the  inner  side  of  art.  vertebral,  in 
a  sulcus  of  the  Atlas,  and  bends  downwards  to  form  a  loop 
with  the  second  cervical  nerve.     Branches  to  the  articulation 
of  the  occiput,  hypoglossus,  gangl.  cervicale  I.,  vagus  and 
sympath.,  art.  vertebralis,  mm.  recti  cap-itis  antici  and  late- 
ralis,  between  which  it  pierces 

b.  Ramus  posterior,  larger  than  a,  passes  in  the  space  between 
mm.  capitis  obliqui  and  red.  postic.,  supplies  these  and  m. 
lateralis,  biventer  and  complexus. 

652.  2.  N.  cervicalis  II., 

far  larger  than  I.,  passes  through  between  atlas  and  dentatus,  far- 
ther backwards  than  the  rest  of  the  spinal  nerves,  and  divides  be- 
neath m.  capit.  obliq.  inferior,  into : 


404  SPECIAL  ANATOMY. 

a.  Ram.  anterior,  passing  under  m.  obliq.  capit.  inferior  for- 
wards and  outwards  ;  gives  branches  to  :  the  loops  with  the 
first  and  third  cervical  nerves,  ram.  descend,  and  hypoglossi, 
nerv.  vagus,  accessorius,  m.  red.  capit.  antic,  major,  sterno- 
cleidomast. 

b.  Ram.  posterior,  sometimes  larger  than  a,  gives  ascending 
and  descending  branches  to  the  posterior  loops,  besides  to  : 
mm.  obliquus  capit.  infer.,  trachelomast.,  complexus,  sple- 
riius,  semi-spinal,  cervic.,  and  the 

Nerv.  occipitalis  major.  This  perforates  the  superior  ex- 
tremity of  the  biventer  cervicis  and  m.  cucullaris,  sup- 
plies these,  ascends  between  nape  and  occiput  internal  to, 
art.  occipital.,  is  then  situated  beneath  the  skin,  gives  a 
curved  branch  to  the  middle  line,  others  outwards  and 
upwards,  and  reaches  as  far  as  the  middle  line  of  the 
vertex.  It  unites  with  ram.  poster,  of  the  third  cervical, 
probably,  also,  with  the  temporal  nerves. 

653.  3.  2V.  cervicalis  III., 

passes  obliquely  upwards  and  outwards  between  the  muscles,  and 
transverse  processes,  through  the  second  intervertebral  foramen, 
and  divides  immediately  into : 

a.  Ram.  anterior.  Uniting  with  the  second  and  fourth  cervical 
nerves,  the  first  cervical  ganglion  of  the  sympathicus,  recur- 
rens  hypoglossi,  it  passes  from  behind  into  the  centre  of  m. 
sterno-ckidom.,  and  gives  : 

1.  N.  occipitalis  minor  ;  frequently  only  a  branch  of  the 

occipit.  major,  passing  forth  behind  m.  sterno-cleidomast. 

over  m.  splenius  capit.  and  proc.  mastoid.  upwards,  to 

the  outer  border  of  the  occiput,  ramifying  in  the  skin. 

Branches  to  the  muscles,  to  n.facialis,  and  the : 

N.  auricularis  superior  for  the  skin  of  the  superior 
part  of  the  external  ear  and  m.  attolens  ;  it  unites  with 
n.facialis  and  occipit.  major. 

2.  IV.  auricularis  magnus,  inclines  round  m.  sterno-cleido- 
mast., forwards  and  upwards  to  its  anterior  border,  where 
it  divides  (at  the  angle  of  the  lower  jaw),  giving  an  auricu- 
lar branch  to  the  posterior  part  of  the  auricle  from  below 
upwards,  which  unites  with  n.  facialis,  and  another  to  the 
occiput,  which  unites  with  n.  occipitalis. 

3.  Nn.  subcutanei  colli  (3).     The  superior  inclines  from  be- 
hind over  m.  sterno-cleidomast.,  obliquely  forwards  and 
upwards,  external  to  v.  jugular,  externa,  supplies  the  skin 


THE  NERVES.  405 

with  an  anterior  branch,  going  through  the  parotis  as  far  as 
the  angle  of  the  mouth,  and  unites  with  nerv.facialis,  with 
a  posterior  branch  directly  upwards  to  the  skin  on  the  ante- 
rior part  of  the  auricle.     The  central  unites  with  the  last, 
giving  branches  upwards  to  the  chin,  downwards  to  the 
inferior  region  of  the  neck  ;  the  inferior  inclines  before  the 
ven.  jugular,  externa  inwards,  sends  branches  to  the  most 
inferior  region  of  the  cervical  skin,  and  on  the  chest, 
b.  Ramus  posterior,  contributes  to  the  posterior  loop,  passes 
under  proc.  spin,  of  the  second  vertebra  and  into  the  skin  of 
the  centre  of  the  nape  of  the  neck.     Branches  to :  m.  trachelo- 
mastoid., transversal.,  complexus,  splenius  capit.,  semi-spinal, 
cervic.  and  trapezius. 

654.  4.  N.  cervicalis  IV., 

passes  out  through  the  third  intervertebral  foramen,  between  the 
third  and  fourth  cervical  vertebrae,  gives  branches  to  art.  vertebralis, 
and  divides  into : 

a.  Ram.  ant.,  giving  branches  to  m.  rectus  capit.  antic,  major, 
longus  colli,  scakn.  med.,  levat.  scapul.,  to  the  third  and  fifth 
loops.  From  the  last : 

1.  Nn.  supraclaviculares,  for  the  most  part  cutaneous  nerves, 
which  radiate  in  the  inferior  trigonum  cervicale  between  m. 
sterno-ckido-mast.,  trapezius  and  clavicle ;  the  anterior  to 
the  clavicle  and  mammary  gland,  the  central  to  the  axilla, 
the  posterior  to  the  scapula. 

2.  Nerv.  phrenicus  respiratorius  internus  (Ch.  Bell),   the 
diaphragmatic  nerve,  arises  from  the  fourth  cervical  nerve, 
and  is  strengthened  hy  filaments  from  the  third,  fifth,  and 
sixth,  even  from  the  second  and  seventh ;  it  unites  with  the 
superior  cervical  ganglion,  sometimes  with  hypoglossus  and 
vagus.     Course :  before  m.  scaknus  anticus,  downwards 
and  inwards,  and  between  art.  and  v.  subclavia  into  the 
cavum  mediast.  antic,  of  the  thorax.     It  is,  here,  between 
Pleura  and  Pericardium,  before  the  roots  of  the  lungs, 
without  distributing  any  branches  ;  on  the  left  side  it  passes 
round  the  apex  of  the  heart  (therefore  longer).     It  divides 
into  two  principal  branches,  which  radiate  upon  the  superior 
surface  of  the  diaphragm,  and  partly  pass  to  its  inferior 
surface,  where  they  anastomose  with  the  plexus  phrenicus 
sympaihici.     It  is  a  mixed  nerve,  and  gives  rise,  by  its 
motor  filaments,  to  the  involuntary  respiratory  movements 
of  the  diaphragm,  the  two   anterior   thirds   of  which   it 
supplies. 


406  SPECIAL  ANATOMY. 

b.  Ram.  posterior  is  small,  is  distributed  in  the  m.  multifid., 
compkxus,  gives  other  branches,  and  terminates  in  the  m. 
splenius  capitis,  or  upon  the  skin. 

Plexus  cervicalis,  formed  by  the  loops  of  the  four  superior  cer- 
vical nerves  (their  anterior  branches),  is  situated  behind  m.  sterno- 
cleidom.  and  ven.  jugularis  interna,  before  the  superior  extremity 
of  m.  scalenus  mcd.  and  levat.  scapulce,  the  third  and  fourth  cervi- 
cal vertebrae.  Its  branches  have  been  described. 

655.  b.  The  four  inferior  cervical  nerves 

supply  more  especially  the  skin  and  muscles  of  the  superior  extre- 
mity, as  their  strong  anterior  branches  interlace,  upon  their  exit 
from  the  intervertebral  foramina,  and  form,  with  the  first  dorsal 
nerve,  the  plexus  brachialis.  The  posterior  branches  are  small, 
incline  round  in.  multifidus,  &c.,  supply  splenius,  biventer,  &c., 
and  terminate  upon  the  skin  of  the  middle  line,  at  the  inferior  re- 
gion of  the  neck. 

656.  Plexus  brachialis. 

Situation:  oblique  from  the  inferior  lateral  region  of  the  neck  as 
far  as  the  inner  side  of  the  head  of  the  humerus.  Its  superior 
broader  portion  lying  between  the  mm.  scaleni,  covered  by  a  fascia, 
is  situated  above  art.  subclavia  in  the  trigonum  cervicale  inferius, 
and  is  connected  above  with  plex.  cervicalis  and  n.  phrenieus.  Its 
central  narrower  portion  between  clavicle  and  first  rib,  behind  art. 
axillaris.  Its  inferior  portion  in  the  axilla,  behind  the  m.  pectoralis 
major,  before  the  scapulo-humeral  articulation,  separated  from  this 
by  the  tendons  of  the  m.  subscapularis,  surrounds  the  art.  axillaris. 
The  branches  are  spirally  interwoven. 

657.  a.  Respiratory  nerves,  the  branches  of  the 

pars  supra-clavicular  is. 

1.  N.  dorsalis  scapulce,  arises  from  the  ram.  anter.  of  the  fifth 
cervical  vertebra,  descends  obliquely  backwards  through  the  m. 
scalen.  medius,  above  levator.  scap.,  and  with  art.  dorsalis  sca- 
pulce  on  the  internal  surface  of  mm.  rhomboidei  ;  distributes  mus- 
cular branches. 

2.  TV.  thoracicus  longus  (posterior)  s.  respiratorius  externus 
Bellii,  arises  with  three  roots,  from  the  fifth  to  seventh  cervical 
nerves,  which  perforate  the  scalenus  medius.     Its  trunk  descends 
on  the  external  surface  of  serratus  antic,  major  as  far  as  its  infe- 
rior extremity,  before  m.  scapularis ;  its  branches  pass  in  arches 
into  the  Serratus  Magnus. 


THE  NERVES.  407 

3.  Nn.  ihoracici  anteriores,  arise  from  the  anterior  portion  of 
the  brachial    plexus,  above  the  m.  subclavius,  from  the  fifth  to 
seventh  cervical  nerves,   pass  inwards,   before  and  behind  art. 
axillaris  to  m.  pectoral,  major  and  minor  ;  a  filament  along  the 
clavicula.     Branches  :  to  m.  subclav.,  deltoid.,  even  to  the  skin  of 
the  mammary  gland. 

4.  IV.  suprascapularis  arises  from  the  fifth,  and  is  enlarged  by 
the  sixth  and  seventh  cervical  nerves,  passes  backwards,  outwards, 
and   downwards   along   the   m.  omo-hyoid.   and   with   the  vena 
transversa  scap.  goes  through  the  incisura  scapul.,  beneath  the 
lig.  transvers.,  whilst  the  artery  passes  over  it.     (In  consequence 
of  becoming  enlarged  the  vein  presses  upon  this  nerve ;    hence 
pains  about  the  shoulder  in  diseases  of  the  heart.)     It  supplies  m. 
supra-  and  infra-spinatus. 

5.  Nn.   subscapulares,   two  branches,  arise  from  the  fifth  to 
seventh  cervical  nerves,  sometimes  from  n.  axillaris,  pass  back- 
wards and  downwards,  giving  branches  to  m.  teres  major,  and 
sinking  into  m.  subscapularis. 

6.  N.  marginalis  scapulce  s.  subscapularis  longus,  arises  from 
the  inferior  central  part  of  the  plexus,  passes  with  art.  subscapul. 
to  the  outer  border  of  the  shoulder  blade,  giving  branches  to  :  m. 
serrat.  antic,  maj.  and  latiss.  dorsi. 

658.  b.  The  nerves  of  the  arm,  branches  of  the  pars  axillaris 

of  the  brachial  plexus. 

There  are  three  cutaneous  and  four  muscular  nerves. 
Of  these,  the 

N.  Axillaris  supplies     the  m.  deltoideus  and  teres 

minor  ; 

IV.  musculO'Cutaneus  the  flexors  of  the  fore-arm ; 

IV.  radialis  the  extensors  of  the  fore- 

arm and  the  hand,  and 
the  supinators  / 

IV.  medianus  and  ulnaris  —          the    flexors    and    prona- 

tors   of   the    hand    and 
fingers. 

659.  Cutaneous  nerves. 

1.  IV.  cutaneus  brachii  internets  (minor  s.  ulnaris},  arises  from 
the  loops  of  the  seventh  cervical  and  first  dorsal  nerves,  passes 
into  the  axilla  on  the  internal  posterior  side  of  ven.  axittar.,  then 
on  the  internal  side  of  the  humerus,  perforates  the  fasc.  brachial. 
in  the  middle  third  and  inclines  outwards.  It  supplies  above,  the 


408  SPECIAL  ANATOMY. 

skin  of  the  arm,  on  the  posterior  surface,  downwards  as  far  as  the 
olecranon,  on  the  inside  ;  as  well  as  the  anterior  surface ;  uniting 
above  the  olecranon  with  the  principal  trunk  of  the  middle  cutane- 
ous nerve. 

2.  N.  cutaneus  medius  s.  internus  major,  arises  from  the  in- 
ferior portion  of  the  plexus  or  from  n.  ulnaris  and  medianus  (at 
first  on  the  ven.  axillar.,  then  on  the  ven.  basilica),  afterwards 
between  them,  downwards  along  the  boundary  of  the  anterior  and 
internal  surface  of  the  upper  arm,  beneath  the  fascia,  giving  above 
branches  to  the  axilla  and  to  the  skin   along  the  m.  biceps,  and 
divides  into  an  external  branch  for  the  anterior  surface  and  an  in- 
ternal for  the  ulnar  border  of  the  fore-arm,  the  branches  of  which 
extend  as  far  as  the  carpal  articulation. 

In  the  bend  of  the  arm  it  is  situated  over  ven.  mediana,  rather 
internally,  towards  the  condylus  internus.  (The  outer  side  of  the 
vein  is  therefore  selected  in  venesection.) 

3.  N.  cutaneus  externus  s.  musculo-cutaneus  s.  perforans  Cas- 
serii,  arises  close  to  the  n.  medianus  or  with  it,  from  the  fifth  to 
the  seventh   cervical   nerves,  perforates  the  m.  coracoideus  and 
passes  obliquely  between  biceps  and  brachial.   intern,  outwards, 
passes  downwards  to  the  v.  cephalica,  and  close   to  this  on  the 
fore-arm,  in  the  inferior  half  of  which  it  divides  into  a  volar  and 
a  branch  for  the  radial  border,  which  terminates  in   the  skin  over 
the    carpal    articulation.     Branches    to :    m.    coraco-brachialis, 
biceps,  brachialis  internus,  and  to  the  skin  of  the  anterior  sur- 
face of  the  lower  arm. 

660.  Muscular  nerves. 

4.  N.  axillaris  s.  circumflexus  humeri,  arises  from  the  inferior, 
middle  part  of  the  plexus,  curves  inwards  and  backwards,  behind 
anconceus  long,  [triceps]  around  the  highest  part  of  the  humerus 
with  art.  circumjl.  humeri  post.,  and  terminates  in  the  skin  be- 
tween the  axilla  and  upper  arm  on  the  posterior  surface.  Branches 
to :  m.  subscapul.,  [?]  tares  major  [?]  and  minor,  deltoid,  to  art. 
axillaris,  the  shoulder  joint,  and  into  the  bones  ;  lastly  : 

N.  cutaneus  humeri  posterior  superior  [there  are  generally 
two,  even  three  branches],  perforates  the  m.  deltoideus, 
and  ramifies  in  the  posterior,  superior,  and  outer  region  of 
the  upper  arm. 

5.  Nero,  ulnaris  s.  cubitalis,  arises  from  the  inner  part  of  the 
plexus,  from  the  sixth  to  the  eighth  cervical,  and  first  dorsal  nerve, 
passes  downwards  on  the  inner  side  of  art.  axillar.  and  brachi- 
alis behind  ven.  axillaris,  perforates  the  fascia,  and  goes  between 


THE  NERVES.  409 

m.  triceps  and  the  lig.  intermusc.  intern,  under  the  skin  to  the 
groove  behind  the  condylus  internus,  between  it  and  olecranon, 
without  giving  off  branches.  Hence  it  passes  between  proc. 
coronoid.  of  ulna  and  flexor  carpi  ulnaris  [between  the  origins 
of  this  muscle],  and  passes  on  the  ulnar  side  of  the  anterior  sur- 
face of  the  fore-arm,  and  divides  in  its  inferior  third  into  a  volar 
and  dorsal  branch.  At  this  point  it  lies  under  m.  flex.  carp, 
ulnaris  and  digitor.  super flcialis,  above  the  profundus  ;  at  first 
over,  then  internal  to  art.  ulnaris.  Branches  to  m.  flex,  carpi 
ulnar.,  digit,  'superfic.  [profundus~\  ;  one  branch  accompanies 
art.  ulnaris  to  the  skin  of  the  volar  surface  of  the  carpus,  as  it 
perforates  the  fascia  antibrachii. 

a.  Ram.  dorsalis  manus,  passes  between  flex,  carpi  ulnaris. 
and  ulna,  supplies  the  skin  on  the  ulnar  border  of  the  fore- 
arm and  divides  on  the  carpus. 

a.  Ram.  sublimis  supplies  the  back  of  the  fifth  and  fourth 
fingers  on  each  side,  that  of  the  third  finger  on  the  ulnar 
side,  with  one  branch. 

b.  Ram.  profundus  (small)  winds  round  over  the  capitu- 
lum  ulnce  upon  the  back  of  the  hand,  where  it  anasto- 
moses towards  the  radial  side. 

b.  Ram.  volaris,  the  continuation  of  the  trunk,  passes  on  the 
inner  side  of  art.  ulnaris  under  the  tendon  of  flexor  carpi, 
and  enters,  between  lig.  carp.  vol.  commune  and  proprium, 
passing  close  to  the  os  pisiforme  into  the  hollow  of  the  hand, 
and  divides  into : 

a.  Ram.  sublimis,  supplies  the  ulnar  side  of  the  little  fin- 
ger on  the  palmar  surface. 

b.  Ram.  medius,  supplies  the  radial  side  of  the  little  and 
the  ulnar  side  of  the  fourth  (ring)  finger. 

c.  Ram.  profundus,  supplies  the  muscles  of  the  little  fin- 
ger, forms  a  loop  on  the  os  pisiforme  with  the  corre- 
sponding branches  of  the  former ;  passes  on  the  arcus 
profundus  arterwsus  to  the  mm.  inter ossei,  adduct.  pol- 
licis  [and  the  two  lumbricales  nearest  the  little  finger.] 

6.  -ZV.  medianus  ;  arises  from  the  fifth  cervical  to  the  first  dorsal 
nerves,  from  the  outer  part  of  the  plexus,  often  united  with  n.  mus- 
culo-cutan. ;  surrounds  art.  axiUaris ;  passes  downwards  on  the 
outer  side  of  art.  brachialis,  on  the  inner  of  m.  biceps,  afterwards 
over  the  artery  and  to  its  inner  side,  through  plica  cubiti  to  the 
forearm,  without  giving  branches.  Descends  from  the  centre  of 
the  bend  of  the  elbow  over  art.  ulnaris  and  behind  m.  pronator 
teres  [often  perforating  it],  is  then  situated  in  the  inferior  half  of 


410  SPECIAL  ANATOMY. 


the  forearm  between  jta?r  digitor  sublimis  andprofundus;  finally, 
it  passes  between  the  tendons  of  flexor .  digit,  sublim.  and  carpi 
radialis  behind  lig.  carpi  volare  proprium  to  the  hollow  of  the 
hand,  where  it  divides  into  four  branches. 

Branches  to:  art.  interossea,  to  the  hollow  of  the  hand  (r.  cuta- 
neus  longus)  [or  palmar  cutaneus],  and  to  all  muscles  of  the  flexor 
side  of  the  fore-arm,  except  flexor  carpi  ulnaris. 

a.  Ram.  volaris  internus,  supplies  the  skin  of  the  hollow  of  the 
hand,  the  third  lumbricalis  [sometimes],  and  the  collateral 
surfaces  of  the  third  and  fourth  fingers. 

b.  Ram.  medius  internus,  supplies  the  second  m.  lumbric.,  and 
the  collateral  surfaces  of  the  second  and  third  fingers. 

c.  Ram.  medius  externus,  supplies  the  first  m.  lumbric.,  and 
the  collateral  surfaces  of  the  second  and  first  fingers,  and  the 
external  of  the  last. 

d.  Ram.  externus,  muscular  branches  for  flexor,  brevis,  abduc- 
tor, and  opponens  pollicis. 

[e.  Ram.  interosseus,  accompanying  the  art.  inteross.  ant.,  sup- 
plies the  pron.  radii  quad.] 

7.  N.  radialis  s.  spiralis,  in  size  and  course  resembling  the 
median,  arises  from  the  fifth  to  the  eighth  cervical  nerves  from  the 
posterior  part  of  the  plexus.  Course:  it  winds  round  the  posterior 
surface  of  the  upper  arm  outwards,  forwards,  and  downwards 
towards  the  fore-arm,  as  it  passes  down  upon  the  anterior  internal 
surface  of  condyl us  externus,  and  divides  at  the  flexure  of  the  arm. 
Position :  at  first  behind  art.  axillaris,  and  separated  by  it  from 
n.  ulnaris  and  medianus,  then  close  to  the  bone  in  a  sulcus  be- 
tween the  heads  of  the  triceps  m.,  finally  passing  out  obliquely 
between  brachialis  internus  and  supinator  longus  over  the  con- 
dylus  externus. 

Branches  :  a  long  cutaneous  branch,  which  reaches  down  as  low 
as  the  back  of  the  hand,  and  to  all  the  extensor  muscles,  except  m. 
extensor  carpi  ulnaris  [?]. 

a.  Ram.  dorsalis  s.  ram.  super ficialis,  continuation  of  the  trunk, 
passes  (on  the  outer  side  of  art.  radial.}  under  supinator  lon- 
gus upon  the  dorsal  surface  of  the  fore-arm,  perforates  the 
fascia  below  its  centre,  and  divides  into  an  external  and  in- 
ternal branch. 

a.  Ram.  anterior,  passes  down  upon  the  extern,  pollic. 

brevis,  gives  branches  to  the  volar  surface  of  the  skin  of 

the  ball   of  the  thumb,  and  terminates   as   n.  dorsal. 

radialis  pollicis  on  that  organ. 

/3.  Ram.  posterior,  supplies  the  dorsal  side  of  the  collateral 


THE  NERVES.  411 

surfaces  of  the  first  and  second,  and  those  of  the  second 
and  third  fingers. 

b.  Ram.  profundus  s.  musmdaris,  passes  through  or  under  m. 
supinaior  brevis  upon  the  dorsal  surface  of  the  fore-arm,  sup- 
plies the  extensor  muscles,  and  passes  close  upon  the  lig.  in- 
terosseum  (as  n.  interosseus  externus},  to  terminate  upon  the 
carpal  articulation. 

661.  IT.  The  Nerves  of  the  Back,  Nervi  dorsales  (twelve  pairs). 

The  first  passes  out  between  the  first  and  second  dorsal,  the  last 
between  the  twelfth  dorsal  and  first  lumbar  vertebra.  Their  roots 
are  smaller,  and  lie  more  widely  asunder  than  those  of  the  other 
spinal  nerves ;  their  trunks  also  are  less  developed.  They  traverse 
a  greater  length  of  the  canal,  spinalis,  form  their  ganglia,  and  soon 
divide  after  their  exit  from  the  intervertebral  foramen.  By  means 
of  frequent  anastomoses,  they  form  arched  loops  with  each  other, 
and  give  off  roots  to  the  nerv.  sympathicus. 

1.  Posterior  branches,  rami  dorsales,  smaller  than  the  anterior, 
turn  round  between  lig.  colli  costce  extern,  and  intern.,  backwards, 
and  divide  into  an  external  and  internal  branch. 

a.  Rami  externi,  turn  outwards  : 

a.  Those  of  the  seven  superior,  smaller,  pass  out  between  the 
transverse  processes;  pass  between  m.  longissim.  and sa- 
cro-lumbalis,  give  branches  to  them,  to  cervical,  descend. 
and  transversal.,  to  levatores  costarum,  and  the  over-lying 
skin. 

/5.  Those  of  the  five  inferior  are  larger,  perforate  the  tendons 
ofserratus  posticus  and  latissimus  dorsi,  and  terminate 
below  in  the  skin. 

b.  Rami  interni,  are  larger  in  the  seven  superior  dorsal  nerves; 
pass  upon  m.  multifid.  spince,  inwards   and   downwards  to- 
wards the  transverse  processes,  give  branches  to  m.  mutifid., 
semi-spinal,  cervicis  and  dorsi,  mm.  inter spinales,  perforate 
the  superficial  muscles,  and  spread  out,  as  the  two  are  asso- 
ciated together,  externally  in  the  skin  of  the  back. 

2.  The  anterior  branches,  nervi  inter costales,  pass  between  the 
ribs  before  the  lig.  colli  costce  intern.,  traverse,  below  the  vasa  in- 

fracostalis,  the  sukus  costalis,  between  mm.  intercostales  externi 
and  interni,  forwards  and  outwards,  and  divide  in  the  middle  be- 
tween vertebrce  and  sternum  into  an  internal  and  external  branch. 
The  anterior  branch  of  the  first  dorsal  nerve  assists  in  forming  the 
plex.  brachialis,  as  its  superior  branch  passes  upwards  behind  art. 


412  SPECIAL  ANATOMY. 

maxillaris  to  the  eighth  cervical  nerve ;  its  inferior  branch  tra- 
verses as  intercostal  nerve  along  the  first  rib. 

a.  Rami  interni  s.  profundi  continue  to  pass  in  the  direction  of 
the  trunk,  along  the  inferior  borders  of  the  ribs  as  far  as  the 
middle  line  of  the  chest  and  abdomen. 

a.  The  thoracic  (r.  thoracici  interni),  these  are  the  branches 
of  the  second  to  the  seventh  intercostal  nerves,  which 
give  small  branches  to  the  mm.  intercostales  and  trian- 
gularis  sterni  (of  the  third  to  the  seventh),  perforate  at 
the  outer  border  of  the  sternum  the  mm.  intercostal,  and 
pectoralis  major,  are  again  reflected  outwards,  supplying 
the  mammary  gland  and  skin,  and  unite  as  internal  cu- 
taneous nerves  of  the  chest  with  the  external. 

(3.  The  abdominal  branches  (r.  abdominales  interni) ; 
these  are,  the  branches  of  the  eighth  to  the  twelfth  inter- 
costal nerves,  are  larger,  give  branches  to  the  mm.  in- 
tercostales,  pass  behind  the  cartilages  of  the  short  ribs, 
and  traverse  between  mm.  obliquus  intern,  and  trans- 
versus  abdom.  to  and  in  the  sheath  of  m.  rectus,  supply- 
ing the  muscles  and  skin  of  the  anterior  abdominal  walls. 

b.  Rami  externi  s.  laterales  perforate  (the  twelfth  excepted)  the 
m.  intercostal,  extern,  from  behind  forwards,  then  pass  forth 
on  the  lateral  walls  of  the  chest  and  abdomen,  and  divide  im- 
mediately into  an  anterior  and  posterior  branch. 

a.  The  thoracic  branches  (r.  thoracici  externi),  that  is,  the 
second  to  the  seventh  branch,  passing  forth  between  the 
digitations  ofm.  serratus  antic,  major.  Their  anterior 
branches  are  reflected  inwards,  and  ramify  in  the  skin 
of  the  thorax.  Their  posterior  branches,  backwards 
upon  n.  latissimus  dorsi,  give  filaments  to  it,  and  ter- 
minate in  the  skin  of  the  back.  The  posterior  branch 
[intercosto-humeral]  of  the  second  and  third  n.  intercos- 
tal, goes  to  the  skin  of  the  upper  arm,  and  forms  the 
posterior  cutaneous  nerves  of  the  superior  third  of  this 
region  of  the  upper  extremity  [Nn.  WrisbergiiJ. 

/3.  The  abdominal  branches  (rami  abdominales  extern.), 
that  is,  the  eighth  to  the  twelfth  branch,  passing  out  be- 
tween the  digitations  of  m.  obliquus  extern.  Their  an- 
terior branches  are  reflected  inwards,  give  a  branch  to 
m.  obliq.  extern.,  and  ramify  in  the  skin  of  the  lower 
part  of  the  anterior  abdominal  parietes.  Their  posterior 
branches  pass  backwards  to  the  skin  of  the  lumbar  re- 
gion. 


THE  NERVES.  413 

662.     III.  The  lumbar,  abdominal  nerves,  Nervi  lumbales, 
(eight  pairs.) 

The  first  passes  out  between  the  twelfth  dorsal  and  first  lumbar 
vertebra,  the  fifth  between  the  fifth  abdominal  and  the  sacrum. 
Their  roots  lie  closer  together,  belong  to  the  cauda  equina,  and 
pass  tolerably  far  downwards  in  the  canal,  spinalis  ;  they  are  not 
united,  like  the  earlier  spinal  nerves,  by  means  of  interposed  fila- 
ments. The  ganglia  of  the  lower  are  situated  in  the  canalis  spi- 
nalis. The  trunk  divides,  soon  after  its  exit  from  the  interverte- 
bral  foramen,  into  an  anterior  and  posterior  branch. 

The  anterior  branches  increase  at  the  origin  from  the  first  to 
the  fifth,  unite  by  means  of  two  or  several  filaments  with  n.  sym- 
pathicuS)  pass  through  m.  psoas  major ,  and  associate  in  loops  be- 
fore the  transverse  processes  of  the  abdominal  vertebrae,  the  four 
superior  of  which  form  plex.  lumbalis,  while  the  fifth  belongs  to 
theplex.  sacralis. 

2.  The  posterior  branches  decrease  in  size  from  the  first  to  the 
fifth,  are  soon  reflected  backwards  between  the  transverse  pro- 
cesses and  their  muscles,  and  divide  into : 

a.  Internal  branches.     They  pass  in  the  groove  on  the  basis  of 
the  transverse  process  to  m.  multifidus  and  inter spinales. 
The  fifth  branch  unites  with  the  first  n.  sacralis. 

b.  External  branches.     They  are  larger,  go  to  mm.  intertrans- 
versarii  and  sacro-lumbalis.     The  three  first  distribute  nn. 
cutanei  superiores  \lumbo- glutceal]  to  the  glutseal  region. 


Plexus  lumbalis. 

The  lumbar  plexus  is  formed  by  the  loops  of  the  second,  third, 
fourth,  and  a  small  branch  of  the  first  abdominal  nerve,  and  is 
situated  on  the  sides  of  the  bodies  of  the  lumbar  vertebrae  between 
the  transverse  processes  and  the  fasciculi  of  psoas  major.  Three 
secondary  and  three  principal  branches  pass  off  from  it,  the  for- 
mer of  which  belong  to  the  first  and  second  lumbar  nerves  as 
nn.  abdominaleS)  and  pass  between  m.  psoas  and  iliacus  on  one 
side  and  the  peritoneum  on  the  other,  to  the  crural  arch ;  the 
latter  supply  the  inferior  extremity. 

664.     a.  The  secondary  branches,  abdominal  brandies. 

1.  JV.  ileo-hypogastricus  arises  from  the  first  lumbar  nerve, 
perforates  the  psoas,  passes  outwards  before  m.  quadrat,  lumbor. 
downwards  towards  the  crista  ilei,  penetrates  m.  transvers.  abdom., 
passes,  between  m.  transversus  and  obliquus  internus,  along  the 


414  SPECIAL  ANATOMY. 

crista  ilei,  and  terminates  in  the  skin  over  the  abdominal  ring  and 
mons  Veneris,  or  passes  through  the  inguinal  canal.  It  supplies 
the  above-mentioned  muscles. 

2.  N.  ileo-inguinalis  arises  from  the  first  lumbar  nerve  or  the 
first  loop,  perforates  m.  psoas  farther  forwards,  and  the  m.  trans- 
versus  in  the  neighbourhood  of  spina  ilei  anterior  super.,  after 
that  the  obliq.  intern.,  and  passes  over  the  spermatic  cord  (or  the 
round   ligament),  through  the  abdominal  ring  to  the  skin  of  the 
pubic  region  (mons  Veneris)  and   the  anterior  external  part  of  the 
scrotum  (or  the  labia  externa),  sometimes  even  to  the  thigh. 

3.  N.  genito-cruralis  arises  from  the  second  lumbar  nerve,  or 
the  second  loop,  perforates  the  psoas  close  in  front,  passes  down- 
wards, forwards   and   outwards   upon    its   anterior  surface,   and 
divides   in   the   inguinal    region    into    an    internal    and  external 
branch. 

a.  Ram.  externus  s.  lumbo-inguinalis,  passes  off  obliquely, 
from  the  psoas  to  the  m.  iliacus  outwards,  and  passes  upon 
this  with  an  external  branch  to  the  spina  anter.  super.,  per- 
forates the  inferior   border  of  the  abdominal  muscles,  and 
supplies  the  skin  of  the  outer  superior  part  of  the  thigh  ; 
with  an  internal,  upon  or  outside  the  art.  cruralis,  through 
the  femoral  ring  to  the  skin  of  the  anterior  superior  part  of 
the  thigh. 

b.  Ram.  internus  s.  n.  spermaticus  externus  [s.  ileo-inguinal] 
runs  through  the  femoral  ring  on  the  inner  side  of  v.  cruralis, 
with  an  external  branch  which  terminates  in  the  inguinal 
glands  over  Poupart's  ligament  and  the  skin  ;  with  an  inter- 
nal branch  through  the  inguinal  canal  upon  the  spermatic 
cord  (or  lig.  uteri  rotund.)  into  the  tunica  vaginalis  propria 
to  m.  cremaster,  testicle,  tunica  dartos,  and  skin  of  the  scro- 
tum (or  to  mons  Veneris  and  the  anterior  extremities  of  the 
labia). 

665.  b.  The  principal  branches,  femoral. 

4.  N.  cutaneus  femoris  anterior  externus  [s.  inguino-cutaneus], 
arises  from  the  second  loop,  perforates  the  psoas,  passes  down  upon 
m.  iliacus  underneath  its  aponeurosis;  behind  art.  circumflexa 
ilei  at  the  outer  extremity  of  lig.  Poupartii  through  a  short  sheath, 
here  perforates  the  fascia  cruralis,  and  descends  on  the  outer  side 
of  the  thigh  as  far  as  the  knee.     Connexions  :  with  the  two  rami 
of  the  genito-cruralis  (plexiform).     Branches  :  to  the  skin  over 
trochanter  major,  and  internally  in  front. 

5.  J!V".  cruralis,  the  middle  and  largest  branch  of  the  lumbar 


THE  NERVES.  415 

plexus,  arises,  especially,  from  the  second,  third,  and  fourth  lum- 
bar nerves,  passes  rather  obliquely  downwards,  outwards  and  for- 
wards, behind  m.  psoas,  then  before  m.  iliacus,  behind  lig.  Pou- 
partii  upon  the  anterior  surface  of  the  thigh,  where  it  immediately 
divides  into  two  principal  branches.  Situation  :  in  the  fossa  ili- 
aca  ;  in  the  fossa  between  psoas  and  iliacus  covered  by  the  fascia 
iliaca  on  the  external  border  of  the  psoas  ;  behind  the  lig.  Pou- 
partii ;  separated  from  the  art.  cruralis  by  its  sheath  and  the 
tendon  of  psoas,  below  the  femoral  ring.  Branches  :  to  m.  psoas 
and  iliacus  pectin&us  [?]  and  the  following : 

1.  N.  cutaneus  femoris  anterior  internus  comes  off  at  Pou- 
part's  ligament,  and  descends  as  far  as  the  outer  surface  of 
the  knee.     It  gives  branches  to  m.  sartorius  and  supplies  the 
skin  of  the  outer  surface  in  the  centre,  and  that  of  the  ante- 
rior and  internal  in  the  lower  third  of  the  thigh. 

2.  N.  cutaneus  femoris  anterior  medius  arises  from  the  anterior 
and  internal  principal  trunk,  descends  in  the  lower  third  of 
the  thigh  outwards,  and  terminates  above  and  outside  the 
patella,. 

3.  N.  patellaris  arises  next  to  the  last  on  the  outside,  below  lig. 
foupartii,  supplies  the  skin  on  the  internal  and  anterior  part 
of  the  lower  extremity  of  the  thigh,  and   turns  over  the  pa- 
tella to  the  anterior  part  of  the  superior  extremity  of  the  leg. 

By  anastomoses  between  the  external  cutaneous  nerves, 
loops  and  superficial  plexuses  arise  upon  the  inferior 
part  of  the  patella. 

4.  Rami  musculares  for :  tensor  fascice  (sometimes  [?]),  for 
vastus  externus  (from  three  to  four),  internus  (one),  m.  sar- 
torius, several,  superficial  and   deep,  which,  perforating  the 
muscle,  pass  to  the  skin  on  the  inner  side  of  the  knee ;  for 
rectus  femoris  and  cruralis. 

5.  Nero,  saphenus  magnus,  the  principal  branch  of  n.  cruralis, 
passes  as  far  as  the  middle  of  the  thigh  on  the  outer  side  of 
art.  cruralis  above  the  passage  of  the  last  through  m.  adductor 
magnus,  and  divides  into  an  internal  and  a  larger  external 
branch. 

a.  Ram.  internus  passes  over  art.  cruralis,  behind  m.  sar- 
torius, then  perforates  it  and  passes  on  the  internal  sur- 
face of  the  knee-joint  to  the  a,nterior  of  the  shin-bone  to 
ramify  in  a  radiating  form  in  the  skin  over  its  upper 
third.     A  branch  passes  backwards  to  the  middle  of  the 
thigh. 

b.  Ramus  externus  is  larger,  passes  over  the  art.  cruralis 


416  SPECIAL  ANATOMY. 

downwards  and  inwards,  comes  forth,  after  being  more 
deeply  seated,  from  between  m.  gracilis  and  sartor.,  and 
descends  on  the  internal  and  anterior  part  of  the  leg,  with 
the  ven.  saphena  ;  it  supplies  the  skin  of  the  inner  part 
of  the  popliteal  region,  of  the  calf,  of  the  inner  malleolus 
and  back  of  the  foot. 

6.  Nervus  obturatorius,  arises  especially  from  the  fourth  lumbar 
nerve,  passes  downwards  posterior  and  internal  to  m.  psoas  with 
the  vasa  obturatoria  close  to  the  lateral  parietes  of  the  pelvis,  and 
enters  the  foramen  in  the  membrana  obturatoria  above  the  artery, 
where  it  divides  for  the  supply  of  the  mm.  obturatorii  [only  exter- 
nus  and  sends  a  few  filaments  to  the  hip-joint]. 

a.  Ram.  anterior  is  larger,  passes  forth  between  adductor  brevis 
and  longus,  supplies  these,  the  gracilis,  the  skin  on  the  internal 
anterior  region  of  the  middle  of  the  thigh,  and,  united  with 
n.  cutan.  fern,  intern,  the  inner  side  of  the  calf  [and  knee — 
hence  pains  in  this  region  in  incipient  disease  of  hip-joint]. 

b.  Ram.  posterior  perforates,  and  supplies  the  adductor  longus 
and  brevis,  and  ramifies  in  the  magnus  as  far  as  the  knee. 

666.          IV.  The  Sacral  Nerves,  Nervi  sacrales, 
(eight  pairs). 

They  arise  (except  the  fifth)  side  by  side  from  the  inferior  en- 
largement of  the  spinal  cord.  Their  roots  descend,  almost  ver- 
tically, in  the  canal,  spinalis,  inside  of  which,  even,  the  ganglia 
of  the  posterior  roots  are  situated.  The  trunks  of  the  united  roots 
are  therefore  longer  than  those  of  the  lumbar  nerves.  They  divide 
soon  after  their  exit  from  the  sacral  foramina,  into  their  anterior 
and  posterior  branches. 

a.  The  anterior  branches  decrease  in  thickness  from  the  second 
to  the  fifth,  pass  out  through  the  foramina  sacralia  antt.,  but 
the  last  between  the  inferior  piece  and  the  cornua  of  the 
sacrum  unite  with  n.  sympathicus,  and  give  branches  to  m. 
pyriformis   and   coccygeus.      The  first   to   the   fourth  give 
branches  to  the  plexus  in  the  depth  of  the  pelvis,  and  form 
the  plexus  ischiadicus  with  the  fifth  lumbar  nerve.     The  fifth 
unites  with  the  fourth  and   the  coccygeal  nerve,  and  goes 
directly  into  the  skin  of  the  anal  region. 

b.  The  posterior  branches  are  less  developed,  the  third  most. 
They  pass  forth  through  the  foram.  sacral,  posteriora,  unite 
with  each  other,  with  the  anterior  branches,  and  with  the  last 
lumbar  and  coccygeal  nerves,  and  pass  as  the  posterior  cuta- 
neous nervesof  the  glutseal  region ;  nn.  clunium posteriores (3) 


THE  NERVES.  417 

667.  Plexus  sacralis  s.  ischiadicus, 

formed  of  the  first,  second  and  third  sacral  nerves,  and  of  branches 
of  the  fourth  and  fifth  abdominal  [lumbar]  nerves;  is  situated  in  a 
direction  downwards  and  outwards  towards  the  inferior  extremity 
of  the  incisura  ischiadica  major  before  the  m.  pyriformis  ;  before 
it,  the  vasa  hypogastrica,  which  separate  it  from  the  peritoneum 
and  rectum.  It  is  connected  above  with  the  lumbar  plexus  [by 
lumbo-sacral  nerve],  in  front  with  the  hypogastric  plexus;  below 
it  continues  into  the  n.  ischiadicus,  and  with  the  smaller  portion  of 
the  muscular  nerves  of  the  glutceus,  the  posterior  region  of  the 
thigh,  and  into  the  pudendal  nerves. 

1.  The  secondary  branches. 

a.  Nn.  hcemorrhoidaks  medii  and  vesicates  inferiores,  are  three 
or  four  twigs  of  the  anterior  branches  of  the  third  sacral  nerves, 
they  give  branches  to  plexus  hypogastricus  (see  n.  sympathic.),pass 
to  the  rectum  and  above  the  vesiculce  seminales  to  the  neck  of  the 
bladder,  in  the  female  as  far  as  the  vagina. 

b.  Nn.  hce7norr}ioidales  inferiores,  the  terminal  filaments  of  the 
anterior  branches  of  the  fourth  sacral   nerve.     This  last  gives 
branches  to  plex.  hypogastricus,  the  prostata,  vagina,  m.  levator 
ani  and  coccygeus. 

1.  N.  glutceus  superior,  arises  from  the  loops  of  the  third  and 
fourth  lumbar  with  the  first  sacral  nerve,  passes  above  m. pyriformis 
with  art.  glutcea  through  the  incisura  ischiad.  major,  anastomoses 
with  the  ischiadic  nerve,  and  divides  immediately  into  two  or  three 
principal  branches,  the  largest  of  which  passes  in  a  curve  to  the 
outer  part  of  the  thigh,  between  glutceus  medius  and  minimus  ;  it 
supplies  the  glutczi  [g.  med.  and  min.]  and  skin  [?],  the  tensor 
fascice,  and  in,  the  pelvis,  the  pyriformis. 

2.  N.  glutceus  inferior,  arises  from  the  loops  of  the  fourth  and 
fifth  lumbar,  and  first  and  second  sacral  nerves,  passes  out  below 
m.  pyriform.  with  art.  ischiadica  from  incisura  major  on  the  in- 
ternal surface  of  glutceus  maximus  ;  ramifies  in  it  and  in  the  skin, 
and  unites  with  the  ischiadic  nerve. 

3.  N.  cutaneus  femoris  posterior  communis,  arises  from  the 
first  and  second  loop  of  the  sacral  nerves,  passes  out  under  m. 
pyriform.  through  incisura  major  with  art.  ischiadica  and  down- 
wards between  tuber  ischii  and  trochanter  major,  dividing  into 
several  branches  : 

a.  Nn.  cutanei  clunium  inferiores  are  reflected  around  the  in- 
ferior border  of  glutceus  maximus,  supplying  the   skin  of 
trochanter  major  and  the  lower  part  of  the  glutseal  region. 
27 


418  SPECIAL  ANATOMY. 

b.  Nn.  scrotales  s.  labiales  are  reflected  beneath  the  m.  glutczus 
maximus  inwards,  and  terminate  in  the  skin  of  the  internal 
superior  part  of  the  scrotum  or  labia  maj.,  sometimes  also  in 
the  perinceum. 

c.  Nn.  cutanei  femoris  posteriores,  for  the  skin  of  the  posterior 
and  inner  part  of  the  thigh  as  far  as  the  posterior  and  outer 
part  of  the  popliteal  region,  whence  filaments  extend  down- 
wards to  the  outer  and  interior  region  of  the  calf. 

4.  N.  pudendus  s.  spermaticus  communis  arises  (variably)  from 
the  flat  cord  of  the  associated  sacral  nerves,  immediately  passes  in 
the  depth  between  lig.  spinoso-sacrum  and  sacro-ischiadicur/i  on 
the  inner  side  of  art.  pudenda  under  m.  levator  ani,  and  divides 
into  : 

a.  Ram.  inferior  s.  N.  perincci,  corresponds  to  the  art.  pudenda 
(with  the  exception  of  art.  dorsalis  penis'),  passes,  above  this, 
jfrom  behind  forwards,  then  between  m.  obturator  intern,  and 
membr.  obturat.  with  a  curve  upwards,  and  terminates  with  a 
superficial  branch  (with  art.  transv.  perin.),  taking  a  course, 
obliquely  inwards  and  forwards,  to  the  lower  part  of  the  scro- 
tum and  the  penis,  with  a  deep  branch  to  the  anterior  part  of 
sphincter  ani,  to  the  bulbo-cavernos.  and  bulbus  urethra,  (in 
the  female  to  sphincter  vagince,  the  labia  and  mons  Veneris). 

b.  Ramus  superior  s.  n.  dorsalis  penis  (n.  clitoridis  of  the 
female),  passes  in  a  curve  (with  art.  pudenda),  at  first  close 
to  the  inner  surface  of  the  tuber  ischii,  then  upwards  between 
levator  ani  and  obturator  internus,  and  beneath  symphysis 
pubis  (surrounded  by  the  veins),  upon  the  dorsum  of  the  penis 
in  the  middle  line,  and  more  superficial  than  art.  dorsalis  ;  it 
divides  into  two  branches,  the  internal  deeper  of  which  goes 
to  the  glans,  the  external  cutaneous  ramifies  on  the  sides  of 
the  penis,  and  forms  a  plexus  which  supplies  the  skin  of  the 
three  superior  fourths  of  the  organ. 

The  nerve  of  the  clitoris  is  finer  and  smaller,  but  takes  pre- 
cisely the  same  course. 

5.  N.  hczmorrhoidalis  infimus  arises,  frequently,  from  n.  pu- 
dendus, passes,  more  internally  than  this,  between  lig.  tuberoso- 
and  spinoso-sacrum,  under  the  levator  ani,  in  the  fat,  divides  and 
passes  to  the  posterior  part  of  the  sphincter  ani  and  the  neighbouring 
skin. 

6.  7V.  ischiadicus,  the  longest  nerve  of  the  body,  arises  from  the 
third  and  fourth   lumbar,  and  the  first,  second  and  third  sacral 
nerves,  passes  out  from  the  incisura  ischiadica  major  below  n. 
pyriformis,  flattened,  descends  between  tuber  ischii  and  trochanter 


THE  NERVES.  41.9 

major,  close  upon  the  rotator  muscles,  covered  by  glutceus  maxi- 
mus,  directly  to  the  posterior  surface  of  the  thigh.  It  here  lies 
enveloped  in  fat,  and  accompanied  by  no  [large]  vessel,  before  the 
long  head  of  m.  biceps  and  before  m.  semitendinosus,  then  in  the 
fossa  between  the  two;  behind  m.  adductor  magnus.  [Above 
gemellus  sup.  it  gives  off  a  branch  which,  passing  behind  the  two 
gemelli  and  obturator  intern. ,  is  lost  in  quadratusfemoris.] 

Distribution.  At  the  breadth  of  three  to  four  fingers  above  the 
knee-joint  (the  commencement  of  the  popliteal  space) ;  even  beforeor 
after  its  exit  from  the  pelvis  it  divides  into  two  principal  branches. 
Branches  ;  superior :  to  mm.  biceps ,  semitendinosus,  -membra- 
nosus,  adductor  magnus  ;  inferior :  to  caput  breve  bicipitis,  to  the 
fat  of  the  knee-joint,  to  the  outer  side  of  the  patella. 

a.  N.  peroneus  s.  fibularis  s.  poplitceus  externus,  the  smaller 
external  branch,  descends  on  the  external  side  of  biceps,  obliquely 
outwards  through  the  popliteal  region,  then  behind  condylus  extern, 
femoris  and  tibice,  between  the  tendons  of  the  biceps  and  the  outer 
head  of  gastrocnemius  ;  outwards  and  rather  forwards,  behind  the 
superior  attachment  of  m.  solceus  to  the  capitulum  fibula,  where 
it  divides  into  one  of  two  superficial  and  deep  branches.  Branches : 
to  biceps  and  knee-joint  (see  n.  ischiadic.) ;  farther  : 

a.  Posterior  cutaneous  branches,  rr.  cutanei  cruris  peroncvi 
posteriores. 

1.  N.  cutan.  medium  internus,  descends  under  the  fascia  in  the 
middle  of  the  posterior  surface  of  the  calf  as  far  as  the  inferior 
extremity  of  the  leg. 

2.  N.  cutan.  medius  externus  s.  communicans  Jibularis  passes 
along  the  outer  half  of  the  calf  and  the  Undo  Achillis,  then 
under  the  external  malleolus  to  the  back  of  the  foot,  supplies 
the  skin  on  its  outer  half,  the  dorsal  surface  of  the  outer  side 
of  the  fifth,  and  the  collateral  surfaces  of  the  fourth  and  fifth 
toes ;  and  unites  with  n.  communicans  tibialis  (which  see). 

3.  N.  cutaneus  externus,  supplies  the  skin  of  the  outer  border 
from  the  superior  to  the  inferior  extremity  of  the  leg. 

/3.  The  superficial  terminal  branches  of  n.  peronceus. 

4.  Ramus  superjicialis  externus  s.  N.  cutaneus  dorsi  pedis  me- 
dius, passes  on  the  outer  side  of  the  fibula,  gives  branches  to 
gastrocnemius  extern.,  peronceus  tertius,  extensor  haUucis 
longus  ;  betakes  itself  to  the  middle  of  the  anterior  surface 
of  the  leg,  perforates  the  fascia,  supplies  the  skin  of  this  part 
and  about  the  external  malleolus  ;  divides  dichotomously  on 


420  SPECIAL  ANATOMY. 

the  dorsum  of  the  foot,  and  supplies  with  an  internal  arched 
branch  the  skin  of  this  region,  as  far  as  the  root  of  the  great 
toe ;  with  an  external  branch  the  collateral  surfaces  of  the 
third  and  fourth  toes. 

5.  Ramus  superficialis  internus  s.  N.  cutaneus  dorsi  pedis  in- 
tern, supplies  the  mm.  peronei,  passes  over  the  ankle  joint 
inwards,  towards  the  internal  malleolus,  supplies  the  skin  on 
the  internal  border  of  the  dorsum  pedis  and  bifurcates.     Its 
internal  branch  supplies  the  inner  surface  of  the  great,  and 
the  collateral  surfaces  of  the  same  and  the  second  toe ;  its 
external  branch  the  collateral  surfaces  of  the  second  and  third 
toes. 

y.  The  deeper  terminal  or  muscular  branch. 

6.  N,  tibialis  anticus  winds  round  the  capitulum  fibulce,  for- 
wards, descends  on  the  anterior  surface  of  lig.  inteross.  out- 
side and  before  art.  tibialis  antica,  between  m.  extensor  digi- 
tor.  longus  communis,  hallucis  and  tibialis  anticus,  gives 
branches  to  these  muscles,  passes  under  lig.  cruciatum,  upon 
the  dorsum  pedis,  into  the  sheath  of  extensor  halluc.  and  bi- 
furcates. 

a.  Ramus  internus,  continuation  of  the  trunk,  passes  under 
art.  metatarsea  (pedicea  ?)  directly  forwards,  between  first 
and  second  os  metatarsi,  unites  with  the  fifth,  and  supplies, 
accordingly,  the  dorsal  side  of  the  collateral  surfaces  of  the 
first  and  second  toes. 

b,  Ramus  externus  passes  transversely  outwards,  close  upon 
the  tarsus,  under  extens.  brevis  halluc.  and  digitor.  com- 
munis,  and  supplies  them. 

b.  N.  tibialis  s.peronteus internus,  descends  as  the  continuation 
of  n.  ischiadicus,  vertically  through  the  popliteal  space,  between 
the  heads  of  the  gastrocnemius,  then  on  the  posterior  surface  of 
the  tibia,  covered  by  m.  soleus,  and  on  the  internal  border  of  ten- 
doAchUlis,  behind  and  under  the  internal  malleolus,  where  it  bi- 
furcates. Situation :  in  the  popliteal  space,  on  the  posterior  and 
outer  side  of  vena  poplitcea,  covered  only  by  the  fascia  /  as  far  as 
tendon  Achillis,  by  mm.  gastrocnemius  and  soleus,  on  the  outer 
side  of  art.  tibialis  postica  ;  behind  and  below  the  malleolus,  co- 
vered by  the  fascia,  in  a  sheath  with  the  vasa  tibialia  (and  behind 
them),  behind  the  tendons  of  m.  tibialis  posticus  and  flexor,  com- 
mun.  digit  longus. 

Branches  :  for  the  posterior  part  of  the  knee-joint,  for  m.  popli- 


THE  NERVES.  421 

tceus,  the  muscles  of  the  calf,  m.  tibialis  postic.  audjlexor  hattucis 
longus.  Farther : 

1.  N.  communicans  tibialis  s.  cutaneus  longus  (s.  saphenus  ex- 
ternus),  descends  behind  the  popliteal  space  and  the  calf,  then 
curves  under  the  external  matteolus  and  unites  with  n.  com- 
munic.  fibularis,  as  : 

N.  dorsalis  extern,  digiti  5,  on  the  outer  border  of  the  foot 
and  to  the  fifth  toe  (see  before). 

2.  N.  cutaneus  plantaris  arises  in  the  centre  of  the  leg,  per- 
forates the  fascia  on  the  tendo  Achillis,  and  passes  to  the  skin 
of  the  heel  and  the  sole. 

3.  N.  plantaris  internus,  arises  under  proc.  internus  calcanei, 
passes  over  m.  abductor  haUucis,  and  between  this  and  flex, 
digit,  commun.  brevis,  and  bifurcates.     Its  internal  smaller 
branch  passes  on  the  inner  border  of  the  sole  to  the  great  toe, 
supplying  the  skin  and  mm.  flexor  and  abductor  brevis.     Its 
external,  branch  bifurcates,  supplies  the  skin,  mm.  lumbricaks 
[only   two]  and  interossei  [?]   and  the  joints,  as  well  as  the 
collateral  plantar  surfaces  of  the  first  and  second,  the  second 
and  third,  the  third  and  fourth  toes. 

4.  N.  plantaris  externus,  is  stronger,  passes  forwards  between 
caro  quadrata  and  flexor,  digitor.  comm.  brevis  to  the  outer 
border  of  the  foot,  gives  branches  to  these  muscles,  and  ab- 
duct, brevis  digit.  5.     Its  superficial  branch  supplies  the  col- 
lateral surfaces  of  the  fourth  and  fifth,  and  the  outer  surface 
of  the  fifth  toe.     Its  deeper  branch  passes  in  a  curve  to  the 
arcus  arter.  plantaris,  inwards  and  forwards,  and  supplies  the 
adductor  hattuc.flex.  digiti  5,  and  interossei. 

668.         V.  The  Coccygeal  Nerves,  Nervi  coccygei, 
(one  or  two  pairs), 

arise  from  the  conus  medullaris  with  a  single  root  which  descends 
in  ihefllium  terminate,  enlarges  at  the  point  of  the  sheath  of  dura 
mater,  passes  out  and  descends  with  two  branches  on  the  middle 
ligament  of  the  sheath  to  the  inferior  extremity  of  the  sacrum. 
The  anterior  branch  is  the  larger,  passes  out  between  the  cornu 
and  the  superior  part  of  the  first  piece  of  the  coccyx,  forwards, 
unites  with  n.  sympathicus  (see  ganglion  coccygeum)  ;  and  with 
the  anterior  branch  of  the  fifth  sacral  nerve. 

The  posterior  branch  passes  immediately  backwards,  and  unites 
with  the  posterior  branch  of  the  fifth  sacral  nerve. 


422 


SPECIAL  ANATOMY. 


[Nerves  of  the  Lower  Extremity  from  the  LUMBAR  PLEXUS. 

Anterior  crural  nerve        supplying  the  flexors  of  the  hip,  sartorius,  and  the 

extensors  of  the  knee  joint. 

Obturator  nerve  —         the  obturator  extern.,  the  adductors  and 

gracilis. 
LUMBO-SACRAL. 

Superior  glutceal 

Cutaneous  branches  - 

SACRAL. 
Internal  pudic 

Inferior  glutasal 

Branches 
Branches 


'  Muscular  branches         — 
External  poplitceal          — 

Internal  poplitceal          — 

(posterior  filial) 
Internal  plantar 
External  plantar 

Cutaneous  branches        — 


glutcBUS  med.  and  min.  and  tensor  vaginas 

femoris. 
the  skin  over  these  muscles. 

muscles  and  skin  of  perineum,  and  parts 

of  the  organs  of  generation,  &c. 
glutcBus  maximus  and  skin  of  pudendal 

and  posterior  femoral  regions. 
Viscera  in  pelvis. 
obturat.  intern.,  pyriform.,  gemelli,  quad. 

femoris. 

the  flexors  of  the  knee, 
the  peroncBal  muscles,  the  flexor  of  foot 

and  extensors  of  toes, 
the  extensors  of  foot  and  long  flexors  of 

toes. 

short  flexors  of  toes. 
the  flex,  ace.,  interossei,  adductor,  hallucis, 

trans,  pedis  and/,  min.  digit. 
the  skin  over  these  muscles.] 


The  Sympathetic  Nerve, 
Nervus  sympathicus  s.  gangliosus, 

This  is  a  string  (connecting  cord)  of  from  twenty-four  to  twenty- 
five  interrupted  ganglia,  found  upon  the  lateral  and  anterior  sur- 
faces of  the  vertebral  column,  before  the  transverse  processes  of  the 
vertebra?,  which  forms  plexuses  on  the  different  organs  by  means 
of  branches  which  pass  off  laterally  from  the  ganglia.  It  receives 
its  roots  from  the  brain,  but  in  great  measure  from  the  spinal  cord, 
as  filaments  pass  from  each  spinal  nerve  to  the  corresponding  gan- 
glion, remaining  here  with  the  already  existing  plexus,  or  continu- 
ing, after  a  longer  or  shorter  course,  from  the  connecting  cord  into 
the  lateral  branches.  [Filaments  also  arise  within  the  ganglia^ 
The  ganglia  correspond,  generally,  to  the  intervertebral  spaces,  and 
are  in  close  relation,  by  means  of  connecting  filaments,  with  all  the 
other  ganglia  of  the  body,  like  a  chain.  The  connecting  cords  of 
the  two  sides  are  associated  before  the  os  coccyx  in  the  ganglion 
coccygeum. 


THE  NERVES.  423 

A.  The  ganglionic  chain,  central  portion, 

is  divided  into  the  cranial,  cervical,  thoracic,  abdominal,  and  pelvic 
portions. 

670.  I.  The  Cranio-cervical  portions,  pars  cepJiplica. 

The  cervical  portion  consists  of  three  (or  four)  ganglia  connected 
together  by  means  of  the  trunk,  is  situated  upon  the  anterior  sur- 
face of  mm.  rectus  capit.  antic,  major  and  longits  cotti,  surrounded 
by  loose  uniting  tissue,  behind  carotis  internet  and  communis,  v. 
vertebralis  and  n.  vagus  (on  their  inner  side). 

The  trunk  between  the  ganglia  is  white,  thinner  or  thicker, 
sometimes  knotty  and  divided,  descends  vertically  to  the  second 
ganglion,  behind  art.  thyreoid.  inferior,  or  directly  to  the  third 
ganglion. 

671.  1.  Ganglion  cervicale  supremum  s.  magnum  is  spindle- 
shaped,  fusiform,  flattened,  rather  concave  on  the  inner  surface  ; 
gray,  even;  half  to  one  inch  long,  one  to  six  lines  broad,  one  to 
three  lines  thick ;  sometimes   fissured  at  the  inferior  extremity, 
and  constricted  (double  ?).     Position :  generally  before  the  proc. 
transvers.  of  the  second  to  the  fourth  cervical  vert.,  before  mm. 
rectus  cap.  antic,  major  and  lon^us  capitis,  posterior  and  internal 
to  carotis  interna,  n.  vagus,  and  hypoglossus  ;  ten  to  twelve  lines 
below  the  introitus  canal,  carotid.     It  receives  its  principal  roots 
from  the  three  first  cervical  nerves,  some  also  from  the  fourth  and 
fifth.     These  enter  into  its  posterior  side,  are  reflected,  and  then 
pass  into  the  rami  and  the  cord  of  the  cervical  portion.  The  branches 
are: 

a.  Ramus  ascendens,  passes  off  from  the  superior  extremity,  and 
divides  into  an  anterior  and  posterior  branch,  which  together  form 
the  cranial  portion  of  the  n.  sympathicus. 

1.  N.jugularis  (r.  posterior)  ascends  from  the  superior  poste- 
rior part  to  the  foram.  jugulare,  and   gives  filaments  to : 
gangl.  petrosum  glosso-phary?igei  ;  gangl.  jugular e  vagi  ; 
to  nerv.  hypoglossus.     The  last,  generally,  enter  the  gangl. 
cervic.  supremum  in  an  isolated  manner,  and  do  not  properly 
go  to  the  hypogloss.,  but  come  from  it. 

2.  N.  caroticus  (ram.  anterior),  ascends  on  the  posterior  and 
internal  surface  of  carotis  inter na,  forming  deYicaie  plexuses, 
and  divides  on  the  first  curvature,  close  beneath  canal  caroti- 
cus, into  an  external  and  internal  branch,  which  pass  toge- 
ther on  the  outer  and  inner  side  of  carotis,  ascending  in  the 
canal  to  the  plexus  cavernosus.     In  the  canal  arise  : 


424  SPECIAL  ANATOMY. 

a.  -ZV".  carotico-tympanicus  inferior,  from  the  external  branch, 
passes  through  a  little  canal  on  the  posterior  outer  wall  of 
can.  carotic.  into  the  tympanum  for  the  nerv.  Jacobsonii 
(see  n.glosso-pharyngeus). 

b.  N.  Vidia^us  profundus  (s.  petrosus  prof,  major),  passes 
through  can.  Vidianus,  with  n.  Vid.  superficial,  to  the  gangl. 
Meckelii  (see  trigeminus),  after  it  has  received  the  superior 
connecting  branches  with  the  plex.  tympanicus. 

N.  petrosus  profundus  minor.   This  passes  out  between 
can.  caroticus  and  the  osseous  tuba  Eustachii. 
c.  Connecting  branches  with  m.  abducens  ;  commonly,  three 
wind  round  the  second  curvature  of  the  carotis  outwards, 
and  pass  into  the  sinus  cavernosus,  to  nerv.  abducens, 
where  this  crosses  the  carotis. 

672.  Plexus  cavernosus,  is  situated  below  and  on  the  inner  side 
of  carotis,  at  its  entrance  into  the  sinus  cavernosus,  is  gray,  per- 
forated by  arteries,  and  gives  numerous  branches,  which  form  a 
plexus,  partly  about  the  carotis  and  its  branches,  and  partly  pass 
to  other  nerves.  Branches : 

1.  For  n.  oculo-motorius.     A  twig  passes,  constantly,  between 
n.  oculo-motor.  and  ophthalmicus  (n.  quinti)  through  fissura 
orbital,  super,  to  the  longer  (or  shorter)  root  of  ganglion  cili- 
are.     Others  pass  close  over  n.  abducens  to  n.  oculo-motorius. 

2.  For  n.  trigeminus.     They  pass  over  the  third  curvature  of 
carotis  from  within  outwards,  and  advance,  partly  into  the  in- 
ternal portion  of  gangl.  Gasseri,  partly  into  n.  ophthalmicus. 
Several  rr.  recurrentes  pass  backwards  to  the  tentorium  cere- 
beUi. 

3.  For  n.  abducens.     They  pass  on  the  internal  inferior  side  of 
n.  abducens  below  the  last  curvature  of  the  carotid ;  some- 
times to  n.  trochlearis. 

4.  For  n.  opticus  and  gangl.  spheno-palatinum.     Some  fila- 
ments go  on  the  inner  side  of  nerv.  abducens  from  the  supe- 
rior anterior  part  of  plex.  cavernosus,  but  only  reach  as  far  as 
the  sheath  of  the  optic  nerve,  and  appear  to  anastomose  with 
filaments  of  the  gangl.  spheno-pal.     (Valentin.) 

5.  Ramuli  sphenoidales  (four  to  six)  pass  inwards  to  the  dura 
mater  around  the  hypophysis  (but  probably  not  into  this),  and 
into  the  sinus  sphenoidalis. 

6.  Ramuli  ad  carotidem  cerebralem  pass  on  the  inner  side  of  n. 
abducens,  on  the  sigmoidal  superior  curvature  of  the  carotis 
to  plex.  n.  mollium. 


THE  NERVES.  425 

b.  Ramu  descendens  is  the  connecting  cord  of  the  n.  sympathi- 
cus  itself  (see  above).     From  it  connecting  filaments  pass  off  to  n. 
cardiacus  and  laryngeus  superior. 

c.  Anterior  branches  of  ganglion  cervicale  I. 

1.  Nervi  mottes  (s.  carotidis  externce),  arise  singly  or  with  a 
common  trunk  (truncm  n.  mottium}  from  the  anterior  surface 
of  the  ganglion,  are  soft,  thin,  and  reddish,  descend  forwards, 
entwine  round  both  carotids,  and  form  plexuses  round  all  the 
rami  of  carotis  externa. 

Plexus  nervorum  mottium  are  as  numerous  as  the  branches 
passing  off  from  the  carotis  extern. ;  also,  pi.  thyreoideus, 
lingualis,  &c.  Above  the  point  of  division  of  the  large 
arteries  they  commonly  form  ganglia  ;  thus  ganglion  in- 
tercaroticum  in  the  angle  between  carotis  interna  and  ex- 
terna. The  following  nerves  have  a  distinct  share  in  these 
plexuses ;  n.  hypoglossus,  vagus,  g1osso-pharyngeus,faci- 
alis,  and  trigeminus.  From  the  plexus  facialis  a  filament 
passes,  as  a  soft  root,  to  the  gang,  maxittare  ;  from  pi. 
maxUlar.  internus,  with  art.  meningea  media  to  ganglion 
oticum. 

2.  N.  cardiacus  superior  s.  longus,  arises  from  the  inferior  ex- 
tremity of  the  ganglion,  or  below  this  even  from  the  trunk, 
enlarged  by  the  laryngeal   branch   of  the  vagus  ,•  passes  on 
the   inner  side   of  n.  sympathicus  before  m.  longus   colli, 
behind  carotis  communis,  in  front,  over  art.  thyreoidea  (on 
the  right  side  close  to  trachea,  on  the  left  before  oesophagus}, 
enters  the  chest  behind  art.  subclavia,  and  passes  with  the 
carotis,  (on  the  left)  and  truncus  anonymus  (on  the  right  side) 
to  the  aorta,  in  the  coats  of  which  it  is,  partly,  lost,  sending 
filaments  on  to  the  posterior  cardiac  and  pulmonary  plexus. 
It  unites  with  :  nn.  molles,  vagus,  and  its  recurrent  branch, 
and    gives     filaments    to    the    thyroid  gland,   m.   sterno-, 
hyo-thyreoid,   constrictor  pharyng.  inferior.     It  sometimes 
forms  two  ganglia. 

a.  Gangl.  cardiacum  superius,  small,  close  under  art.  thyreoid. 
inferior. 

b.  Gangl.  cardiacum  inferius,  s.  Wrisbergi,  larger,  in  the  tho- 
rax (upon  the  right  side,  where  the  nerve  is  generally  stronger). 

G13.  2.  Ganglion  cervicale  medium,  roundish,  elliptical,  smaller 
than  the  superior  cervical  ganglion,  is  larger  in  one  instance  than 
in  another,  but  almost  always  present;  it  is  placed  on  the  trunk  of 
n.  sympathicus,  between  the  superior  and  inferior  cervical  gan- 


426  SPECIAL  ANATOMY. 

glion  on  the  art.  thyreoid  inf.,  receiving  rarauli  from  the  fifth  and 
sixth,  or  fifth  to  the  seventh  cervical  nerves,  and  the  principal  fila- 
ments of  plex.  thyreoideus  inferior  (is  not  to  be  confounded  with 
the  ganglionic  enlargement  before  the  fourth  and  fifth  cervical  ver- 
tebrae ;  this  is  often  wanting).  Between  it  and  the  inferior  cervi- 
cal we  find,  almost  always,  small  ganglia  interposed. 

a.  Plexus  thyreoideus  inferior •,  passes  from  the  cervical  portion, 
form  plexuses  around  the  art.  thyr.  inf.,  gives  branches  to  the 
thyroid  gland,  and  receives  those  of:  the  plexus  of  the  cardiac 
nerves  in  the  inferior  part  of  the  neck,  from  n.  recurrens,  and 
the  trunk  of  the  vagus.  In  it  lies  before  or  behind  art.  thyreoid. 
infer,  a  gangl.  thyreoideum  inferius. 

b.  N.  cardiacus  medius,  arises  from  or  below  the  gangl.  c.  me- 
dium, passes  downwards  and  inwards  behind  the  carotis,  form 
plexus  around  this  (forming  in  the  thorax  the  gangl.  cardiac, 
medium),  and  enter  along  it  the  posterior  cardiac  plexus ;  it 
unites  with  :  plex.  thyreoid.  infer.,  with  branches  from  gangl. 
infimum  c.  and  n.  vagus. 

674.  3.  Ganglion  cervicale  infimum  s.  stellatum,  flat,  round- 
ish, or  three  to  four  cornered,  rarely  double,  sometimes  blended 
with  the  first  thoracic  ganglion,  lying   before  the  root  of  proc. 
transv.  of  the  seventh  cervical  vert.,  or  on  the  neck  of  the  first  rib, 
higher  or  lower  upon  the  art.  vertebral,  behind  art.  subclavia.     Its 
roots  come  from  the  sixth  and  seventh,  also  from  fourth,  fifth,  and 
eighth  cervical  nerves.     Its  branches  are  : 

a.  N.  cardiacus  infimus,  half  a  line  thick,  passes  downwards 
and  inwards,  with  the  trunk  of  the  vagus,  and  then  on  the 
arcus  aortcB  to  the  inferior  cardiac  plexus  ;  is  sometimes  want- 
ing upon  the  right  side,  forms  united  with  n.  card,  medius, 
the  thick  (crassus)  cardiac  nerves.     Connexions  :  with  plex. 
vertebral.,  subclav.,  laryng.  infer,  and  vagus. 

b.  Branches  (three)  for  art.  vertebralis,  ascending  on  this  in  the 
canal,  vertebral.,  surrounding  it  like  a  plexus,  and  anasto- 
mosing with  the  cervical  nerves. 

c.  Branches  (two)  for  art.  subclavia,  forming  loops  about  it,  and 
sinking  into  the  first  thoracic  ganglion. 

d.  The  trunk  of  n.  sympath.,  between  the  lowest  cervical  and 
first  thoracic  ganglion,  divides  and  descends  before  and  behind 
art.  subclavia. 

675.  II.  Pars  thoracica  n.  sympathici. 

The  thoracic  portion  descends  along  the  vertebral  column  (from 


THE  NERVES.  427 

the  first  to  the  third  ganglion,  upon  the  heads  of  the  ribs,  then 
more  externally),  through  the  thorax,  and  divided,  between  the 
external  and  middle  crus  of  the  diaphragm,  into  the  abdomen. 
Before  it  is  covered  by  the  pleura ;  behind  it  pass  the  vasa  and 
nerv.  intercost. ;  close  to  that  of  the  right  side  the  v.  azygos.  Its 
ganglia : 

Ganglia  ihoracica  (eleven  to  twelve)  are  flat,  generally  tri- 
angular, with  the  apex  directed  outwards,  and  they  are  applied 
to  the  outer  side  of  the  trunk.  The  two  first  and  the  twelfth 
are  the  most  developed,  but  less  so  than  the  cervical  ganglia. 
The  first  is  covered,  partly,  by  art.  subclavia  and  vertebral. 
They  contain  a  single  or  threefold  root  from  the  intercostal 
nerves,  and  give  branches  :  to  the  cardiac,  pulmonary,  ceso- 
phageal,  and  aortic  plexuses,  for  the  bodies  of  the  vertebra? 
and  the  intercostal  spaces.  Lastly : 

The  roots  to  the  nervi  splanchnici,  the  visceral  branches. 

676.  III.  Pars  lumbalis  n.  sympathici. 

The  lumbar  portion  descends  on  the  sides  of  the  bodies  of  the 
lumbar  vertebrae  internal  to  the  m.  psoas,  and  unites  above  and 
below  by  means  of  transverse  cords  with  the  one  of  the  other  side. 
The  trunk  is  single  as  well  as  double  and  triple.  Its  ganglia : 

Ganglia  lumbalia  (four  to  five)  are  small,  flat,  and  elongated, 

frequently  blending  one  with  another,  so  that  only  two  or 

three  appear  to  be  present  (as  in  the  neck) ;  grayish-red,  like 

the  rest  of  the  ganglia,  and  lying  on  the  left  behind  aorta 

abdominalis,  on  the  right  behind   v.  cava.     Their  single, 

double,  triple  or  five-fold  roots,  from  the  anterior  branches  of 

the  lumbar  nerves,  are  very  long,  and  pass  into  them,  around 

the  bodies  of  the  vertebrae,  under  m.  psoas.     Branches : 

To  aorta  abdominalis,  artt.  lumbales,  hypogastrica,  and  the 

plexuses  of  the  same  names,  n.  renalis  infer.,  poster.,  and 

filaments  between  n.  renalis  and  spermaticus. 

677.  IV.  Pars  sacralis  et  coccygeus. 

The  pelvic  portion  descends,  divided  into  two  larger  filaments, 
on  the  anterior  surface  of  the  sacrum,  to  the  inner  side  of  for am. 
sacralia  anteriora.  Its  trunk  is  very  delicate,  approaches  more 
and  more  the  farther  it  descends  to  that  of  the  other  side,  and 
unites  by  means  of  transverse  filaments  with  it,  and  the  plexus 
about  the  art.  sacralis  media,  and  terminates  with  the  gangl.  coc- 
cygeum.  Its  ganglia : 


428  SPECIAL  ANATOMY. 

Ganglia  sacralia  (four  to  five,  or  six)  are  very  variable  in 
situation,  shape,  and  number,  the  superior  generally  the 
thicker ;  they  lie  close  to  the  exit  of  the  anterior  roots  of  the 
sacral  nerves,  from  which  they  receive  two  thick  roots. 
Branches : 

To  art.  hypogastrica  and  their  branches,  rectum  and  pelvic 

plexus. 

Plexus  sacralis  medius  commences  even  upon  the  fourth 
lumbar  vertebra,  descends  on  the  anterior  surface  of  the 
sacrum,  becomes  larger  as  far  as  the  fourth  piece  of  the 
sacrum,  and  forms  four  to  five  ganglionic  circles  about  the 
art.  sacralis  media,  becomes  more  delicate  on  the  coccyx,  and 
terminates  in  the 

678.  Ganglion  coccygeum. 

An  azygos,  small  ganglion,  in  which  the  most  external  filaments 
of  the  n.  sympathici  of  the  two  sides  blend  together.  It  is  situated 
upon  the  anterior  surface  of  the  coccyx,  unites  with  the  coccygeal 
nerves,  and  gives  several  minute  filaments  to  the  apex  of  the  os 
coccyx. 

B.  Visceral  branches  and  plexuses. 

679.  a.  Rami  splanchnici  (s.  pars  thoracica). 

1.  Nerv.  splanchnicus  supremus,  is  not  constant,  it  arises  from 
the  cardiac  plexus,  and  receives  roots  from  the  first  to  the  sixth 
thoracic  ganglia.     Its  course  varies,  sinking  into  the  vagus,  or  with 
the  aorta  into  the  abdomen  to  the  plexus  mesaraicus  superior  and 
renalis. 

2.  JV.  splanchnicus  major,  arises  with  many  roots  from  the  fifth 
to  the  eleventh  or  all  the  thoracic  ganglia,  descends  along  the  verte- 
bral bodies,  becomes  flattened,  passes  between  the  external  or  inter- 
nal and  middle  crus  of  the  diaphragm  (or  through  hiatus  aortic.) 
in  great  measure  to  the  gang,  semilunare  of  its  own  side.     The 
right  sends  a.  portion  of  its  fibres,  to  the  left,  towards  the  spleen  ; 
the  left  towards  the  right,  so  that  they  cross. 

3.  N.  splanchnicus  minor,  arises  from  the  eleventh  or  twelfth 
thoracic  ganglion  or  higher,  passes  outwards  close  to  2,  sometimes 
united  with  it,  into  the  lower  part  of  plex.  cceliacus,  often  also  into 
plex.  renalis. 

4.  N".  splanchnicus  inferior  s.  renalis  posterior,  arises  from  the 
twelfth  thoracic  ganglion,  anastomoses  with  3,  and  passes  to  plex. 
cceliac.,  renalis,  and  supra-renalis. 


THE  NERVES.  429 

The  nn.  splanchnici  are  white,  the  plexus,  into  which  they  enter 
gray. 

680.  b.  Plexuses  in  the  abdomen. 

I.  Plexus  Solaris  (cadiati  s.  mesenterici)  comprehends  the  great 
plexus  of  nerves  on  the  aorta,  from  the  origin  of  art.  ccdiaca  and 
mesaraica  super,  as  far  as  the  commencement  of  the  renal  arteries, 
lying  behind  the  peritoneum,  deeply,  behind  the  regio  epigastrica, 
and  forming  very  large  ganglia,  from  which  numerous  branches, 
interlacing  with  each  other,  pass  off,  and  which  anastomose  with 
n.  vagus,  phrenicus,  with  other  branches  of  the  sympathicus,  a 
less  number  with  the  lumbar  nerves.  The  principal  mass  of  them 
forms  the  two : 

1 .  Ganglia  semilunaria  (s.  magna  ccdiaca  s.  cerebrum  abdo- 
minale),  two  reddish,  bridge-like  masses  of  ganglion,  which  are 
situated  on  the  inner  sides  of  the  supra-renal  capsules. 

Into  these  ganglia  the  white  nn.  splanchnici  major  and  minor 
betake  themselves  ;  from  them  gray  branches  pass  out,  as : 

1 .  Rami  phrenici,  uniting  with  posterior  branches  of  n .  phreni- 
cus  and  forming  plexus  about  the  artt.  phrenices  inferr.  on 
the  right  and  left,  entering  into  the  fleshy  portion  of  the 
diaphragm,  and  connecting  themselves  with  the  hepatic  and 
suprarenal  plexus. 

2.  Rami  suprarenales  (eight  to  sixteen)  form,  particularly 
upon  the  posterior  surface  of  the  suprarenal  capsules,  plexus 
suprarenales,  which  are  connected  with  n.  phrenicus, vagus, 
and  with  the  renal  plexus. 

3.  Rami  hepatici,  arise  from  the  two  large  ganglia  and  that 
part  of  the  plexus  Solaris  which  lies  transversely  over  the 
art.  hepatica  before  the  aorta  ;  and  forms  : 

a.  Plexus  arteriosus  hepaticus  s.  dexter,  on  the  hepatic 
artery  and  ductus  hepaticus  within  the  liver ;  where  it 
anastomoses  with  the 

b.  Plexus  venosus.     From  this  plexuses  go  to  the  gall 
bladder  (also  from  a),  ductus  cysticus,  and  choledochus, 
which  are  in  connexion  with  those  of  the  pancreas, 
duodenum,  and  stomach. 

4.  Rami  gastrici  (white)   form,  especially  upon  the  art. 
coronar.ventric.  sinistra,  a  plexus  (pkx.curvatur. minor.), 
anastomoses  with  the  branches  of  n.  vagus  (which  see) 
lying  before  it,  pancreatic,  splenic,  and  hepatic  plexuses  ; 
forming  a  coronet  around  the  port,  pylorica. 

5.  Rami  lienales,  forming  the  plex.  lienalis  on  the  splenic 


430  SPECIAL  ANATOMY. 

artery  for  the  spleen,  and  giving  branches  to  the  pancreas 

andjundus  ventriculi. 

2.  Plexus  mesentericus  superior,  a  dense  plexus  of  whitish-gray 
nerves  at  the  origin  of  art.  mesent.  super.,  contains  on  the  left  side 
a  large  ganglion,  which  is  connected  with  gangl.  codiacum.  Be- 
fore it  lies  the  pancreas,  and  it  receives  the  pkx.  pancreaticus,  as 
well  as  the  intestines  to  which  the  branches  of  art.  mesent.  sup. 
go,  supporting  the  plexus. 

II.  Plexus  intermesentericus  aorta  (s.  aorticus  abdominalis), 
lies  between  art.  mesenterica  superior  and  inferior,  forms  ganglia, 
and  unites  with  the  mesenteric,  renal,  inferior  caval  and  spermatic 
plexus,  and  sends  branches  to  the  sciatic  and  vesical  plexus. 

III.  Plexus  mesentericus  inferior,  accompanies  the  arteries  of  the 
same  name  and  its  branches ;  unites  in  the  meso-rectum  with  the 
sciatic  plexus. 

IV.  Plexus  renales,  are  situated  before  and  behind  the  renal  ves- 
sels ;  are  superior,  middle,  and  inferior,  forming  small  ganglia,  and 
are  connected  with  the  principal  ganglia  (see  above).     In  the  kid- 
neys the  nerves  pass  with  the  arteries,  give  filaments  to  the  renal 
calyces,  and  twine  around  the  straight  urinary  canaliculi. 

V.  Plexus  vena  cavce  inferiores,  are  but  slightly  developed,  arise 
especially  from  pi.  intermesentericus,  connected  with  renal,  sper- 
matic, and  hepatic  plexus. 

681.  C.  The  Pelvic  Plexus. 

I.  Plexus  divisionis  aortce  abdominalis,  a  superior  and  inferior. 
The  superior  lies  under  the  origin  of  art.  mesenterica  inferior,  pass- 
ing a  little  to  the  left ;  its  right  portion  passes  upon  art.  hypogas- 
tric.  dexter,  the  left  on  the  art.  h&morrh.  intern,  to  the  pi.  hce- 
morrh.  intern.    The  inferior  is  more  delicate,  lies  between  the  two 
art.  iliacce,  and  goes  into  the  plex.  hypogastrici. 

II.  Plexus  hcemorrhoidalis  superior  s.  S.  romani,  lies  between 
the  two  layers  of  the  superior  (sigmoid  flexure)  meso-rectum,  is  in 
connexion  with  the  nerves  of  the  vas  deferens,  and  especially  of 
the  left  ureter. 

III.  Plexus  hypogastrici,  a  superior  azygos  and  two  inferior 
lateral. 

1 .  Plexus  h.  impar,  goes  on  the  right  side  of  the  art.  iliaca, 
passing  off  from  the  plexus  at  the  place  of  division  of  the 
aorta,  and  enters  right  and  left  the 

2.  Plexus  h.  lateraks.  These  descend  on  the  artt.  hypogastr.; 
form  long  plexuses,  and  are  surrounded  by  a  ligamentous 
mass,     They  are  in  connexion,  below,  with 


THE  NERVES.  431 

IV.  Plexus  hcemorrhoidales  inferiores,  a  right  and  a  left,  con- 
nected with  the  superior  plexus  of  the  rectum,  receiving  branches 
from  the  sacral  nerves. 

V.  Plexus  vesicates,  ascend  partly  at  the  sides  of  the  urinary 
bladder,  partly  horizontally  forwards  to  the  cottum  vesicce  and  to 
the  prostata  (plex.  prostatici).     Filaments  pass  off  from  it  to  the 
vesiculce  seminales,  vasa  deferentia,  and  form  plex.  spermatici, 
which  are  connected  above  with  the  renal  plexus ,  and  continue  into 
the  plexus  testicularis. 

VI.  Plexus  cavernosi,  arise  especially  in  the  pi.  prostatici  and 
from  branches  of  the  sacral  nerves,  perforate  the  fibrous  mass 
about  isthmus  and  bulbus  urethra,  and  partly  cross,  as  the  one 
enters  into  the  right,  the  other  into  the  left  spongy  body. 

In  the  female,  instead  of  branches  for  prostate,  vas  deferens, 
&c.,  there  are  corresponding  filaments  for  uterus  and  vagina,  ova- 
rium  and  tuba. 

The  posterior  and  lateral  plexus  uterini  arise,  generally,  from 
plex.  hypogastr.,  the  anterior  on  the  contrary,  generally,  from  the 
anterior  branches  of  the  third  and  fourth  sacral  nerves.  They 
entwine  about  the  veins  and  enter  into  the  substance  of  the  uterus. 


TOPOGRAPHICAL  ANATOMY. 


LITERATURE. 

Cock,  Edward.    Practical  Anatomy  of  the  Nerves  and  Vessels  supplying 

the  Head,  Neck,  and  Chest.     1835. 

Burns.    Surgical  Anatomy  of  the  Head  and  Neck.     1811. 
Morton.  Thos.     Surgical  Anatomy  of  the  principal  Regions  of  the  Human 

Body.     Royal  8vo.     Plates. 
Ellis,  Viner.    Anatomical  Demonstrations. 
Lawrence  <f-  Watt.    Anatomico-chirurgical  Views  of  the  Nose,  Mouth,  &c. 

Lond.  1809. 


435 


TOPOGRAPHICAL  SURVEY  OF  THE  MORE  IMPORTANT 
REGIONS  OF  THE  BODY. 

The  Head. 

682.  1.  Regio  occipito-frontalis,  comprehends  the  cranial  vault, 
above  a  line  between  protuberantia  occipitalis,  proc.  mastoideus, 
and  root  of  the  nose.     Thickness  of  section  :=£".     Composition: 
1.  External  skin  (thick,  and  covered  with  hair).     2.  Very  thick 
fibre-cellular  tissue  containing  fat,  with   superficial  vessels  and 
nerves.     3.  M.  epicranim  with  the  galea.     4.  Loose  fibro-cellu- 
lar  tissue.     5.  Pericranium  (firmly  attached  to  the  sutures  by 
vasa  emissaria  and  prolongations  of  the  dura  mater).     6.  Bones 
(strongest  in  front  in  the  central  line,  where  is  crista  frontalis). 
7.  Dura  mater — with  sinus  longitudinalis  in  the  middle  line — 
torcular  Herophili  at  the  tuber  occipitale, — (sinus  later  alls  thence 
to  the  inferior  posterior  angle  of  the  parietal  bones).     S.  Arach- 
noidea,  pia,  cerebrum. 

683.  2.  Regio  temporalis,  temples,  is  bounded,  anteriorly,  by 
proc.  orbital,  of  frontal  bone ;  behind,  by  the  root  of  proc.  zygo- 
matic.  and  meatus  auditorius  ;  below,  by  zygomatic  arch  ;  above, 
by  linea  temporalis  (semicircular'). 

Thickness  :  ==  12'"  (before  and  below);  =  6'"  (above  and  be- 
hind.) Parts  :  1.  Skin  (behind  beset  with  hair).  2.  Fibro-cel- 
lular  tissue  containing  fat,  with  art.  temporalis,  which  divides  into 
frontal  and  parietal  branches  at  a  distance  of  15'"  above  the  zy- 
goma, 4'"  from  the  external  auditory  .meatus.  3.  M.  attottens 
auricula  and  fasc.  superficialis.  4.  Loose  fibro-cellular  tissue. 
5.  Fascia  temporalis,  between  the  two  layers  of  which  below,  a 
triangular  space  with  fat  and  art.  temporal,  med.  6.  M.  tempo- 
ralis ;  anteriorly  fat,  vasa  et  neiva  temporal,  profundi.  7.  Pe- 
riosteum and  bones, — -pars  squamosa  temporal.,  os  parietal.,  fron- 
tal., ala  magna  sphenoid.,  os  zygomatic.  8.  Art.  meningea 
media  ;  two  fingers'  breadth  removed  (and  above)  from  proc. 
orbitalis  oss.  zygomat.  9.  Dura  mate)',  &c. 

684.  3.  Aural  region  (see  Organon  auditus). 

685.  4.  Regio-mastoidea,  is  bounded,  in  front,  by  the  groove 
between  the  cartilage  of  the  ear  and  proc.  mastoid. ;  behind  and 
above,  by  the  curved  line  at  which  the  growth  of  hair  terminates : 


436  TOPOGRAPHICAL  ANATOMY. 

below,  by  the  apex  of  proc.  mastoid.  Parts  :  1.  Closely-applied 
external  skin  and  fatless  fibre-cellular  tissue.  2.  M.  retrakens 
auricula,  occipital.,  sterno-mastoid.,  below  the. last  m.  splenius. 
3.  The  anterior  (auricular}  vessels,  nerves,  and  lymphatic  glands 
in  the  groove  behind  the  ear,  below  m.  retrahens  ;  behind,  below 
the  skin,  vasa  et.  nn.  mastoidei.  4.  Periosteum  and  bones — pars 
mastoid.  of  temporal  bone,  the  posterior  inferior  angle  of  parietal, 
and  a  little  way  from  occipital  bone  ',foram.  mastoid.,  sulcus  late- 
ralis  (a  small  portion) ;  suiur.  mastoid.  and  squamosa  ;  cellul.  mas- 
toidece.  5.  Dura  mater  with  (a  portion  of)  the  sinus  later  alls, 
and  tentor.  cerebelli. 

In  the  new-born  infant — the  posterior  lateral  fontanelle. 

[Dissection.  1.  An  incision  from  the  root  of  the  nose  to  the  external  occi- 
pital protuberance,  in  the  middle  line.  2.  In  front,  an  incision  from  the  root 
of  the  nose  extending  outwards  along  the  eyebrows  to  the  anterior  extremity 
of  the  zygoma.  3.  Behind,  an  incision  from  the  external  occipital  protuberance 
transversely  outwards  to  the  apex  of  the  proc.  mastoideus.  The  section  should 
be  carried  through  the  skin  and  subjacent  fibro-cellular  tissue,  which  are 
then  to  be  reflected  outwards  towards  the  ear,  with  very  great  care.  TRANS.] 

686.  5.  Nasal  region,  Reg.  nasalis. 

Interior  of  the  nose.  The  opening  of  the  lacrymal  canal — sur- 
rounded by  a  fold  of  mucous  membrane — lies  behind  a  projection 
of  the  proc.  nasalis  of  the  upper  jaw,  an  inch  behind  the  anterior 
nasal  openings,  on  the  external  nasal  wall.  The  inferior  turbinate 
bone  is  distant  two  lines  from  the  floor  of  the  nasal  cavity.  [This 
varies  considerably.] 

The  opening  of  the  Eustachian  tube  is  found  in  the  middle  of 
the  side  wall  of  the  posterior  nasal  opening,  equally  as  far  removed 
from  the  anterior,  as  the  incisor  teeth  from  the  uvula. 

687.  6.  The  Mouth,  Cavitas  oris. 
(See  before,  "  Cavities  of  the  Face.") 

a.  Arch  of  the  palate.     Parts:  1.  Mucous  membrane  (firmly 
connected  to  a  fibrous  cellular  tissue)  with  nn.  palatini  posterr. 

2.  Vasa  et  nn.  palatini  medii  at  the  internal  part  of  the  alveolus. 

3.  Vasa  et  nn.  alveolares  behind  and  infraorbitales  before,  on  the 
external  part  of  the  alveolus.     4.  Palate  and  superior  maxillary 
bones. 

b.  Soft  palate — velum  pendulum  palati — extended  transversely 
across,  behind  the  arch  of  the  palate,  four-sided,  five  lines  high,  is 
on  both  sides  covered  with  mucous  membrane  which  anteriorly 


THE  HEAD.  437 

passes  upon  the  vault  of  the  palate,  behind  upon  the  choance,  is 
bounded  at  the  sides  by  the  palate,  and  terminates  in  the  palatine 
arches ;  in  the  centre  of  the  inferior  surface — the  uvula.  Parts : 
from  before  backwards:  1.  Anterior  mucous  membrane.  2.  Layer 
of  mucous  glands.  3.  Fibrous  fascia  of  mm.  tensores  palati  with 
the  insertions  of  glosso-  and  pliaryngo-palatini.  4.  Levatores 
palati.  5.  Layer  of  glands  with  azygos  [levatores']  uvulce.  6. 
Posterior  mucous  membrane. 

c.  Tonsil  glands,  reg.   tonsillaris,  lie   between  the    palatine 
arches,  assist  in  forming  the  isthmus  faucium,  and  bounded  ex- 
ternally by  the  carotis  internet,  between  the  great  cornua  of  the 
hyoid  bone  and  the  angle_of  the  lower  jaw.     Parts  :  from  within 
outwards :    1 .  Oral  mucous  membrane.      2.  M.  Glosso-palatin. 
before,  pharyngo-palat.  behind  the  tonsils.    3.  Tonsil  with  circul. 
'nervos.  tonsillar.  (from  glosso-pharyng.  and  gangl.  cervic.  super.). 

4.  Constrict,  pharyng.  super,  externally.    5.  Fibro-cellular  tissue, 
nerves.     6.  Plexus  venos.  pharyng.     7.  Carotis  interna,  eight  to 
ten  lines  behind  and  external  to  the  tonsils. 

The  lymphatics  pass  into  the  submaxillary  glands  [lymphatic]. 

[Dissection.  The  pharynx  and  upper  portion  of  the  oesophagus,  the  larynx 
and  upper  rings  of  the  trachea  with  the  surrounding  soft  parts,  the  bones  of 
the  face,  and  the  anterior  half  of  those  of  the  cranium,  are  to  be  removed 
from  the  subject.  The  section  of  the  bones  of  the  basis  cranii  must  be  made 
posterior  to  the  roots  of  the  styloid  processes  of  the  temporal  bones,  and 
through  the  basilar  portion  of  the  occipital,  between  the  origins  of  the  supe- 
rior and  middle  constrictor  muscles  of  the  pharynx,  before,  and  the  insertion 
of  the  rectus  anticus  major  muscle,  behind.  After  dissecting  the  pharyngeal 
muscles  by  removing  the  cellular  tissue  about  them,  a  vertical  division  of 
them  should  be  made  through  the  raphe  in  the  middle  line  behind.  The  pos- 
terior wall  of  the  pharynx  being  now  turned  aside,  the  parts  described  under 

5.  and  6.,  a,  b,  c,  may  be  examined  after  inspection  and  removal  of  the  mu- 
cous membrane.     TRANS.] 

d.  Malar  region,  reg.  malaris.     Over  the  malar  bone  the  skin 
is  very  delicate  and  rich  in  blood-vessels  ;  under  it  fibres  orbicul. 
palpebr. ;  under  these  the  zygomatici  ;  behind,  art.  transv.faciei  ,• 
below,  rami  zygomat.  n.  facialis — Pars  masseterica.     1.  Skin 
and  much  fat.     2.  The  anterior  border  of  parotis  and  rami  buc- 
cales  n.  facial.,  ductus  Stenonianus,  behind  from  8  to  9'",  in  front 
4'"  below  the  zygomatic  bone  (with  art.  transv.fac.  on  its  superior 
margin),  its  opening  in  the  region  of  the  first  and  second  molar 
teeth,  4'"   before  the  masseter  m.     3.    M.  masseter.     4.  Lower 
jaw ;  in  the  incisura  sigmoid :  the  deep  vessels  and  nerves  of  the 


438  TOPOGRAPHICAL  ANATOMY. 

masseter.  5.  Below,  n.  lingualis,  ram.  mylohyoid.,  n.  dental, 
infer.,  m.  pterygoid.  internus  ;  above,  between  the  last  and  max- 
illa super. :  art.  maxillar.  intern.,  nn.  dental,  infer,  and  tem- 
poral, superfic.,  lig.  laterale  internum,  which  separates  the  prece- 
ding from  ram.  lingualis  n.  trigemini. 

[Dissection.  1.  Carry  an  incision  through  the  skin,  only,  from  the  inner 
angle  of  the  eyelids  along  the  lower  border  of  the  orbit  to  the  outer  angle  of 
the  lids,  thence  parallel  with  the  zygoma  to  its  temporal  root.  2.  An  inci- 
sion from  the  inner  angle  of  the  eyelids  to  the  commissure  of  the  lip,  then  to 
the  anterior  border  of  the  masseter  muscle  upon  the  inferior  maxillary  bone, 
and  thence  parallel  with  the  lower  edge  of  the  horizontal  ramus  of  this  bone 
to  its  angle.  Reflect  the  skin  towards  the  sterno-cleido-mast.  m.,  and  dissect 
the  parts  1,  2,  and  3. 

Dissect  away  carefully  the  parotid  gland,  leaving  it  attached  by  its  duct. 

Now,  saw  through  the  temporal  root  of  the  zygoma  and  the  malar  bone, 
divide  the  fascias  attached  to  the  zygoma  above,  and  reflect  it,  together  with 
the  masseter  muscle,  carefully,  downwards.  The  parts,  4.,  will  be  exposed, 
the  vessels  and  nerves  close  to  the  posterior  border  of  the  temporal  muscle. 
Detach  the  masseter  from  its  insertion,  and  leave  it  suspended  by  its  nerve. 
The  insertion  of  the  temporal  muscle  (the  coronoid  process  of  the  lower  jaw) 
is  now  to  be  sawn  through,  and,  with  the  muscle,  turned  upwards.  The 
pterygoid  muscles  are  exposed,  and  the  parts,  5.,  may  be  dissected.  Two 
incisions  are  required  to  remove  the  coronoid  process ;  one,  vertical,  parallel 
with  the  posterior  border  of  the  ascending  ramus,  and  passing  through  the 
centre  of  the  incisura  sigmoidalis ;  the  other,  transverse,  and  parallel  with 
the  border  of  the  alveolus.  The  two  incisions  should  meet  in  about  the  cen- 
tre of  the  ascending  ramus.  TRANS.] 

Pars  intermaxillaris — the  anterior  portion  of  the  cheek  ;  be- 
tween the  upper  and  lower  jaws. 

e.  Floor  of  the  mouth.  The  tongue  with  ihefrenulum,  on  the 
sides  of  which,  close  beneath  the  tongue  the  openings  of  the  ductus 
Wharton.,  at  the  sides  of  the  tongue  artt.  ranincz,  and  more  exter- 
nally vena  ranince.  Mm.  mylohyoid.  shuts  in  the  cavity  of  the 
mouth  ;  below  it  the  anterior  belly  of  biventer,  the  skin. 

[Dissection.  To  examine  these  parts  and  their  relations  accurately,  it  is 
necessary,  after  removing  the  skin  and  displaying  the  soft  parts,  to  make  a 
vertical  section  of  the  lower  jaw,  on  the  outer  side  of,  not  through,  the  sym- 
physis ;  in  fact,  between  the  lower  incisor  teeth  and  first  cuspidatus.  Then, 
dividing  the  mucous  membrane  of  the  mouth  at  its  attachment  to  the  lower 
jaw,  the  tongue  may  be  drawn  forwards,  and  the  anatomy  of  this  region  stu- 
died. A  bristle  may  be  passed  through  the  duot  (Wharton's)  of  the  submax- 
illary  gland.  The  openings  of  the  sublingual  glands  by  the  sides  of  the 
tongue  should  also  be  examined.  TRANS.] 


THE  HEAD.  439 

688.  7.  Cavity  of  the  Gullet  (s.  Pharynx). 

The  entrance  to  the  larynx  lies  in  the  anterior  part  of  the  pha- 
rynx, balow  the  isthmus  faucium. 

[Dissection:  see  under  6.  above,  after  c.     TRANS.] 
639.  8.  Orbital  region,  regie  orbitalis. 

a.  Eyebrows.     About  the  inner  third  of  the  superior  margin 
of  the  orbit  the   n.frontalis  passes  out,  besides  the  artery. 

b.  Eyelids.     1.  Skin  (very  delicate).     2.  Loose  fatless  areolar 
tissue  (which  becomes  easily  infiltrated  with  serum).     3.  M.  or- 
bicular, pcdpbr.     4.  Artt.  palpebrales.    5.   Tarsus  and  lig.  latum 
palpbr. ;  at  the  border  of  the  orbital  margin  areolar  tissue  contain- 
ing fat.     6.  Conjunctiva. 

At  the  internal  angle  of  the  eyelid:  1.  Most  delicate  skin.  2. 
Venous  plexus.  3.  Lig.  palpebr.  intern.  4.  Lacrymal  sac,  which 
is  separated  externally  by  a  fibrous  layer  from  the  caruncula,  be- 
low the  last,  and  rather  externally,  the  thin  roof  of  the  antrum 
Highmori,  and  the  origin  of  m.  obliq.  inferior. 

690.  9.  Zygomatic  fossa,  Fossa  zygomatica, 

below  the  temples,  above  the  masseter,  external  to  the  orbits,  inter- 
nal to  the  parotis.  The  superficial  portion  is  connected  with  the 
deep  (fossa  spheno-maxillaris)  by  fissura  pterygo-maxillaris  ; 
that  with  the  orbita  by  fiss.  orbitalis  inferior.  It  is  formed  by  the : 

a.  Sphenoid  ;  b.  posterior  part  of  sup.  maxillary  ;  c.  palate ;  d. 
condyle  of  infer,  maxillary  ;  e.  a  portion  of  the  temporal ;  and  f. 
ethmoid  bone. 

Parts  ;  below  the  zygoma  and  the  insertion  of  m.  temporalis  : 
1.  Vasa  temporalia  masseteric.  2.  M.  Pterygoid  extern,  with  art. 
maxiUar.  intern,  betweeen  its  two  portions,  and  plex.  ven.  ptery- 
goid.  3.  Below  the  insertion  of  m.  pteryg.  extern,  internally  n. 
lingualis,  in  the  centre  n.  dental,  infer.,  externally  temporal  super- 
ficialis.  In  the  fossa  spheno-maxillaris  from  above  to  below ; 
(v.  opthalmica,  n.  ophthalmic.,  oculomotor.,  pathetic.,  abducens  in 
thejissura.  orbit,  superior)  ;  n.  maxiUar.  super,  from  behind  for- 
wards ;  ganglion  Meckelii  on  the  outer  side  offoram.  spheno-pala- 
tinum. 

[Dissection.    As  described  in  the  second  part,  under  b,  d.     TRANS.] 

691.  10.  Parotid  region,  Regio  parotidea, 

is  bounded,  anteriorly,  by  the  posterior  border  of  ram.  maxiUar. 
infer. ;  behind,  by  proc.  mastoid.  and  meatus  auditor,  extern.  / 
above,  by  zygoma  ;  below,  by  the  angle  of  the  lower  jaw,  and  a 


440  TOPOGRAPHICAL  ANATOMY. 

horizontal  line  backwards  ;  internally,  by  proc.  styloideus,  lig. 
stylo-maxillar., — hyoideum.  The  parotis  occupies  nearly  the 
whole  of  this  space,  and  is  all  round  enclosed  in  fascia.  Parts 
from  without  inwards:  1.  Skin,  slightly  hairy  (behind  the  beard 
of  the  cheek).  2.  Close  areolar  tissue,  having  little  fat,  with 
branches  of  n.  auricular,  from  plex.  cervicalis.  3.  Lymphatic 
glands.  4.  Parotis ;  from  it  upwards  :  art.,  ven.  temp.,  rr.  tem- 
poral, n.  maxill.  infer. ;  behind :  art.  auricular,  post.,  and  rr. 
auricul.  n.  facial,  and  plexus  cervical.  Inside  the  parotis:  1. 
behind,  n.facialis,  6'"  deep;  in  front  its  branches  £"  deep.  2. 
F.  parotidece.  3.  deeper,  carotis  externa,  close  to  the  proc.  styloid. 

[Dissection.     As  described  in  the  first  part,  under  6,  d.     TRANS.] 

The  Trunk. 
692.         I.  The  Neck.     Anterior  cervical  region. 

a.  Supra  hyoideal,  reg.  supra-hyoidea,  lies  between  lower  jaw 
and  hyoid  bone,  forms  the  floor  of  the  mouth. 

In  the  middle  line  (submental  region)  lie  :  1.  skin  (in  the  male 
hairy)  with  a  thicker  or  thinner  layer  of  fat.  2.  Mm.  platysmam. 
with  superficial  nerves  of  the  plex.  cervical,  and  branches  of  art. 
mentalis.  3.  Ventr.  anter.  m.  digastric.  4.  Deep  branches  of 
art.  submentalis.  5.  Mm.  mylohyoidei.  6.  Mm.  geniohyoidei. 
7.  Geriio-glossi.  8.  In  front  and  above :  glandula  sublinguaL, 
with  ductus  Wfiartonian.  and  the  mucous  membrane  of  the  mouth  ; 
below  and  behind,  the  tongue.  Laterally,  we  find  over  the  m. 
platysmam.  the  following  parts  :  1.  Layer  of  fasc.  cervical.  2. 
Plexus  of  art.  and  ven.  submental.  (facialis),  the  vasa  lymphat. 
facial.,  the  n,  mylo-hyoid.  (dental,  infer.'),  branches  of  facialis 
and  superficial  branches  of  plexus  cervicalis  ;  between  them  gland, 
submaxillar.  and  lymphatic  glands.  3.  M.  mylohyoideus.  4. 
Above  and  before,  gland.  sublinguaL,  duct.  Wharton.  (above),  n. 
lingual,  and  art.  sublinguaL  (below  the  glands),  then  beneath 
the  mucous  membrane  below  and  behind :  1.  N.  hypogloss.  and 
ven.  lingual,  close  to  the  great  cornua  of  the  hyoid  bone.  2.  M. 
stylo-,  hyoglossus.  3.  Art.  lingual,  and  n.  glosso-pharyngeus 
and  tongue. 

Yen.  facialis  passes  upon  the  external,  art.  facialis  on  the  in- 
ternal side  of  the  gland,  submaxillaris  ;  art.  submental.  below  it 
on  the  inferior  border  of  the  lower  jaw ;  n.  mylohyoideus  still 
deeper. 

b.  Infrahyoideal  region,  reg.  infrahyoidea.  s.  inter stitium  jugu- 
lare,  a  triangle  the  base  of  which  is  formed  by  the  os  hyoides,  the 


THE  TRUNK.  441 

sides  by  the  internal  borders  of  the  musculi  sterno-mastoidei,  and 
the  apex  by  the  first  piece  of  the  sternum. 

1.  The  central  portion   consists,   above,  of  the  reg.  laryngea 
(larynx) ;  the  centre,  of  the  reg.  thyreoidea  (thyroid  cartilage  and 
thy.  gland);  below,  of  the  fossa  supra-sternalis  s.jugulum,  tra- 
cheal  fossa. 

2.  Superior  lateral  portion,  trigonum  cervicale  superius,  is  a 
triangular  fossa,  bounded,  above,  by  the  posterior  belly  of  digas- 
tricus,  in  front,  by  the  superior  belly  of  omohyoideus,  behind,  by 
the  anterior  border  of  sterno-mastoid.,  and  above  passing  into  the 
reg.  parotidea.     Below  lies  the  sterno-mast.,  close  to  and  before 
the  trachea. 

Position  of  the  parts:  1.  Skin  and  loose  fibro-cellular  tissue, 
with  little  fat.  2.  Above,  fascia  cervicalis  and  mm.platysmam. ; 
below,  in  the  jugulum,  a  space  between  the  anterior  and  middle 
layer  of  the  fasc.  cervicalis,  which  sends  a  process  externally  into 
the  reg.  supraclavicularis  behind  the  m.  sterno-mast.,  and  contains 
in  the  middle  line  a  descending  branch  of  ven.  ihyreoid.  inf.  (fre- 
quently) ;  some  lymphatic  glands ;  laterally,  the  ven.  jugularis 
anterior.  3.  Mm.  sterno-hyoidei,  above,  m.  omohyoideus.  4. 
Mm.  thyreo-hyoidei,  branches  of  n.  hypogloss.  and  mm.  sterno-thy- 
reoidei.  5.  Thyroid  gland,  with  the  deep  layer  offasc.  cervical., 
which  is  attached  to  the  posterior  surface  of  the  sternum  and  larynx. 
6.  Plexus  venosus  thyreoidus,  and,  near  the  sternum,  v.  subclavia 
sinistra  and  truncus  anonymus  (but  the  last  rests  entirely  beneath 
this  region,  as  it  ascends  obliquely  from  left  to  right).  In  the  angle 
between  the  two  :  7.  The  trachea.  8.  Pharynx  above  ;  below  and 
to  the  right,  n.  recurrens  dexter  ;  below  and  to  the  left,  oesophagus, 
and  on  its  anterior  surface,  n.  recurrens  sinistra,  and  a  transverse 
branch  of  art.  thyreoid.  inf.  9.  Loose  fibro-cellular  tissue  ;  under 
that  mm.  longi  coUi,  and  the  fifth  to  the  seventh  cervical  vertebra?. 

In  the  trigonum  cervicale  superius  ;  1.  The  skin  and  thin  layer 
of  fibro-cellular  tissue.  2.  M.platysmam.  3.  Nn.  cervicale  su- 
perfic.,  and  behind  n.  auricularis  (s.  plex.  cervic.).  4.  Ven.  jugu- 
lar, externa.  5.  M.  digastric,  and  stylohyoid.  6.  Lymphatic 
glands,  surrounded  with  venous  plexuses.  7.  N.  hypogtossus, 
carotis  externa,  which  is  to  be  felt  in  the  inferior  angle  of  the  tri- 
gonum. Farther  inwards  and  backwards,  carotis  interna  (which 
see),  with  the  parts  surrounding  it. 

693.  Lateral  surfaces  of  the  Neck,  Reg.  supraclavicularis. 

1.  Reg.  sterno-mastoidea.  The  sterno-cleido-mast,.  is  covered 
by  a  loose  fibro-cellular  tissue,  in  which  the  ven.  jugular,  extern. 
descends  from  before  backwards.  It  covers : 


442  TOPOGRAPHICAL  ANATOMY. 

a.  Below  (the  m.  omohyoideus) :    1.  Loose  fibro-cellular  tissue, 
wherein  is  a  branch  of  ven.  jugul.  extern,  (anter.)     2.  The  deep 
layer  offasc.  cervical,  and  m.  omohyoideus.     3.  The  external  bor- 
der of  m.  sterno-hyoid.,  and  -thyreoideus.     4.  The  junction  of  w. 
jugular,  intern,  and  extern,  behind  articul.  sterno-ckidoidea  (in  the 

angle  the  duct,  thoracicus  opens).  5.  N.  phrenicus  outside  (close 
to  scalenus  antic.  m.},  1"  distant  from  n.  vagus  (close  to  carotis 
commun.);  between  the  two,  n.  sympathicus.  6.  Right,  the  supe- 
rior extremity  of  truncus  anonymus  (carotis  and  art.  subclav. 
dextra) ;  left,  carotis  comm.,  art.  subclav.  sinistra.  7.  Right,  n. 
recurrens ;  left,  ductus  thorac.,  the  superior  extremity  of  the 
pleura.  8.  M.  longus  cotti  and  vertebral  column.  The  carotis 
lies  1"  removed  from  the  anterior  border  of  m.  sterno-cleido-mast. ; 
the  right  rather  nearer. 

b.  Above  (between  tmwhyoid.and  splenius):    1.  Plex.  cervical. 
2.  Art.  cervical,  ascend.,  m.  rect.  antic,  cap.  magn.,  scaleni,  levat. 
scapul.j  splenius  colli.     3.  Proc.  transversi  and  art.  vertebralis. 
Quite  above,  splenius  capitis,  &c. 

2.  Trigonum  cervicale  inferius,  supraclavicular  fossa,  a  trian- 
gle, the  base  of  which  is  formed  by  the  clavicular  (the  first  rib),  the 
sides  by  the  anterior  border  of  m.  cucullaris  and  the  posterior  of 
sterno-cleido-mast.,  and  which  is  divided  by  the  post,  belly  of  m. 
omohyoideus  into  an  inferior  smaller,  and  a  superior  larger  triangle. 

Position  of  the  parts:  1.  Skin,  m.  platysmam.  2.  Before,  v. 
jugular,  extern.;  above,  nn.  subcutan.  colli,  accessor.  Willisii.  3. 
M.  omohyoid.  and  the  deep  layer  offasc.  cervicalis.  4.  Art.  trans- 
versa  colli,  supraclavicular.,  ven.  subclavia  (between  the  first  rib 
and  clavicle).  5.  In  front,  scalenus  anticus  (on  the  internal  bor- 
der of  which  n.  phrenicus) ;  behind,  scalenus  rued,  (and  post.} ;  be- 
tween the  two,  above  and  outside  the  origin  of  plex.  brachialis; 
below  and  within,  art.  subclavia,  upon  the  first  rib,  close  to  the 
tubercle,  separated  by  scalenus  antic,  from  ven.  subclavia.  Ex- 
ternal to  the  scaleni  the  artery  lies  close  behind  the  vein,  in  the 
direction  of  m.  omohyoid.  6.  The  transverse  processes  of  the 
cervical  vertebras,  mm.  intertransvers.,  art.  profund.  cervic.  and 
vertebralis. 

Posterior  surface  of  the  neck,  nape,  cervix. 

[Dissection.  1.  An  incision  should  be  made  in  the  middle  line,  through 
the  skin  only,  from  the  chin  to  the  sternum.  2.  From  the  mastoid  process  to 
the  acromion.  3.  From  the  mastoid  process  to  the  centre  of  the  upper  border 
of  the  sternum. 

Two  triangular  flaps  of  skin  are  thus  formed,  attached  by  their  bases,  the 
one,  above,  to  the  horizontal  ramus  of  the  lower  jaw  ;  the  other,  below,  to  the 


THE  TRUNK.  443 

clavicle.  These  are  to  be  reflected  upwards  and  downwards.  The  platysma 
myoides  is  to  be  dissected,  the  course  of  the  external  jugular  vein  examined, 
and  the  muscle  divided  transversely  and  reflected.  The  parts  above  described 
occupying  the  various  regions,  the  boundaries  of  which  should  be  accurately 
defined,  may  be  now  exposed  and  dissected  in  succession.  TRANS.] 

694.  Chest,  Thorax. 

1.  Reg.  sternalis.  a.  Skin  thick,  in  the  male  hairy,  in  the  cen- 
tral line  firmly  attached,     b.  fibro-cellular  tissue,  with  the  tendons 
of  sterno-mastoid.,  pecioraks,  rect.  abdom.  c.  sternum :  above,  lig. 
interclaviculare.     d.  M.  triangular,  sterni.     e.  Mediastina  an- 
tica  ;  at  the  inferior  part  of  the  pericardium ;  above  the  thymus, 
ven.  anonyma. 

2.  Reg.  mammiUaris,  beneath  the  claviculce,  on  the  sides  of  the 
sternum.     Parts:  1.  Very  delicate  skin,  especially  on  the  nipple. 
2.  Fibro-cellular  tissue  with  much  fat,  in  which,  above,  nn.  clavi- 
culares,  mammary  arteries  and  nerves.     3.  Mammary  gland,  with 
branches  of  vasa  mammar.  interna   and  thoracica.     4.    Loose 
fibro-cellular  tissue.    5.  M.  pectoral,  major,  minor ;  serratus  mag- 
mis.     6.  Ribs,  intercostal  muscles. 

3.  Reg.  costalis,  costal  region,     a.  Before  the  ribs,  on  the  supe- 
rior half  of  the  thorax;  behind  the  shoulder:  1.  Skin  and  thick 
fibro-cellular  tissue.     2.  M.  trapezium,  latiss.  dorsi.    3.  Rhomboi- 
deus.     4.  Above,  m.  serratus  postic.  sup.     5.  Ribs. 

On  the  inferior  half:  skin,  fibro-cellular  tissue,  branches  of  nn. 
and  vasa  intercost.  Then  :  1.  M.  rect.  abdom.  (in  its  sheath), 
obliq.  extern.,  serratus  magn.,  and  costal  portion  of  latissim.  dorsi. 
2.  Ribs. 

b.  Between  the  ribs  (spatium  intercostale) :  1.  Mm.  intercostales 
externi.     2.  Nervi  et  vasa  intercost.  (on  the  inferior  border,  of 
angulus  costa,  also  at  the  superior  border  of  each  rib).     3.  Mm. 
intercost.  intern.  .,y> 

c.  Behind  the  ribs  :  1.  Fibro-cellular  tissue  (and  mm.  infracos- 
tales).     2.  Vasa  mammar.  interna,  above,  two  lines  from  the  bor- 
der of  the  sternum,  below,  before  m.  triangular,  sterni.     3.  Pleura. 
(The  chest  should  not  be  opened  upon  the  right  side  below  the 
fourth,  upon  the  left  below  the  third  intercostal  space  (reckoning 
from  below),  if  it  is  wished  to  avoid  injury  to  the  diaphragm). 

4.  Regio  dorsalis,  dorsal  region. 

695.  Cavity  of  the  Thorax. 

1.  Regio  mediastini,  is  bounded  in  front  by  the  sternum,  behind 
by  the  vertebrae,  above  by  the  neck,  below  by  the  diaphragm,  right 


444  TOPOGRAPHICAL  ANATOMY. 

and  left  by  pleura  and  the  lungs.  Directed  towards  the  left  and 
downwards,  this  space  is  broad  above,  and  especially  below,  in  the 
centre  very  narrow,  also  X-shaped.  In  the  centre  at  the  posterior 
third  lie  the  roots  of  the  lungs. 

a.  Inferior  half  corresponds  to  the  inferior  of  the  sternum.  Parts  : 
1.  Loose,  fibre-cellular  containing  adipose  tissue.    2.  Anterior  part 
of  the  pericardium.     3.  Heart,  origin  of  the  great  arteries,  termi- 
nation of  ven.  cava  super.     4.   Vv.  pulmonales  /  and  post,  part  of 
pericardium.     5.  Lymphatic  glands  and  oesophagus  (in  the  central 
line)  surrounded  by  plex.  nerv.  cesophag.     6.  Aorta  descend,  to 
the  left ;  ven.  azygos  to  the  right ;  duct,  thorac.  in  the  centre  and 
behind.     7.  Fibro-cellular  containing  adipose  tissue,  in  which  are 
nn.  splanchnici,  artt.  and  w.  inter costales.     8.  Dorsal  vertebra. 

b.  Superior  half,  behind  the  superior  half  of  the  sternum.   Parts  : 
1.  Loose  fibro-cellular  tissue,  containing  adipose  (thymus  gland) 
with  small  branches  of  mammary  artery.    2.  Above  :  v.subclavia 
sinistra  ;  most  superior  part  of  the  pericardium,  below.    3.  Trun- 
CKS  anonym,  and  v.  cava  superior,  in  front ;  termination  of  art. 
pulmonalis,   lig.   arteriosum,  arcus  aortce  (with  n.  recurrens)  ; 
carotis  and  art.  subclavia  sinistra  (with  n.  vagus  and  phrenicus) 
to  the  left ;  curve  of  ven.  azygos  (with  n.  vagus  and  phrenic.)  to 
the  right.     4.  In  the  middle  line :  termination  of  the  trachea  (left 
n.  recurrens) ;  under  that  a  rhombic  space  between  the  two  bronchi 
and  rami  art.  pulmonal. ;  in  which   are  lymphatic  glands.     5. 
(Esophagus,  behind  bronchus  sinistra.    6.  Duct,  thoracic,  behind 
the  oesophagus.     7.  Loose  fibro-cellular  tissue  with  the  superior 
intercostal    vessels.     8.    Extremity  of  m.  long,  colli.     9.  Dors, 
vert. 

c.  Roots  of  the  lungs,  above  the  centre  and  in  the  posterior 
third.     Parts :  1.  The  pulmonary  veins,  two  on  a  side.    2.  Ramus 
art.  pulmonal.     3.  Bronchus,  covered  before  by  plex.  pulmonal. 
anter.,  behind  by  n.  vagus  and  plex.  pulmon.  posterior.     They 
divide  the  anterior  from  the  posterior  mediastinum  and  n.  phrenic. 
from  vagus. 

2.  Lateral  parts.     The  lungs  invested  by  the  pleura  pulmonalis. 


Abdomen,  Venter. 

1.  Reg.  epigastrica,  extends  from  the  termination  of  the  ster- 
num and  the  eighth  rib  as  far  as  the  inferior  border  of  the  twelfth, 
and  to  about  the  breadth  of  two  fingers  above  the  navel.  A  cen- 
tral and  two  lateral  portions  are  described. 

a.  Epigastrium,  scrobiculus  cordis,  gastric  fossa,  that  is,  the 
triangular,  central  part  between  sternum  and  the  cartilages  of  the 
six  last  ribs.  Behind  the  delicate,  sensitive  skin,  thefasc.  superfic. 


THE  TRUNK.  445 

with  the  cutaneous  branches  of  sixth  to  eighth  nerv.  intercostal.  ; 
proc.  ensiform.,  linea  alba,  m.  rectus  in  its  sheath  ;  vasa  mamma- 
ria  ;  laterally,  m.  transversus  and  pars  costal,  diaphragma.  The 
following  parts  are  met  with  : 

1.  The  left  lobe  of  the  liver  ;  2.  the  cardia  ;  3.  pars  pykrica  of 
stomach  ;  4.  the  small  omentum  and  a  part  of  the  large ;  5.  the 
second  and  third  portions  of  duodenum  ;  6.  Pancreas  surrounded 
by  lymphatic  glands,  with  truncus  ccdiacus  ;  7.  the  large  vessels, 
crura  diaphragmat. ;  first  and  second  lumbar  vertebrae. 

b.  Hypochondrium  dextrum,  contains  the  costal  portion  of  the 
diaphragm  and  lig.  suspensorium  hepatis,  is  filled  up  by  the  liver. 
The  fundus  of  the  gall  bladder  corresponds  to  the  cartilage  of  the 
ninth  rib.     We  find  therein :  1.  Flexura  coli  dextra.     2.  The  first 
portion  of  duodenum  and  cap.  pancreat.     3.  Before  the  foram. 
Winslow.  :  art.  hepatica  in  front  [to  the  left]  ;  ductus  hepatic., 
cystic,  and  commencement  of  choledochus  in  the  centre  [to  the 
right]  ;  ven.  porta  [between  the  two],  and  termination  of  n.  vagus 
dexter  behind.     The  right  lobe  of  the  liver  rests  against  the  right 
kidney  and  supra-renal  capsules  above  and  behind. 

c.  Hypochondrium  sinistrum,  contains  the  fundus  ventriculi  ; 
above  and  before  a  small  process  of  the  left  lobe  of  the  liver ;  be- 
hind and  to  the  left  the  spleen  with  lig.  gastro-splenicum,  between 
the  anterior  lamina  of  which  the  vasa  brevia,  between  the  posterior 
the  vasa  lienalia  and  the  cauda  pancreatis.     Behind  the  stomach 
and  below  the  spleen:  the  superior  extremity  of  colon,  descend., 
the  left  kidney,  and  caps,  supra  renales. 

Both  regg.  hypochondr.  present,  1.  A  thick  skin.  2.  Fibro-cel- 
lular  containing  adipose  tissue,  cutaneous  veins  and  branches  of 
the  inferior  nn.  inter costales.  3.  A  thin  aponeurosis  and  fascia 
superficial.  4.  Mm.  obliq.  extern,  and  latissim.  dorsi.  5.  Costa 
spurice  with  mm.  inter  costales.  6.  Diaphragm  ;  on  the  inferior 
surface  of  which  (abdominal  cavity)  the  peritoneum  ;  on  the  su- 
perior surface  (thoracic  cavity)  pleura  costalis  and  phrenica. 

697.  2.  Regio  mesogastrica.  This  is  the  part  below  the  last 
ribs  and  above  the  hip  bones ;  distinguished  in  the  centre  as  regio 
umbilicalis,  at  the  sides  regg.  lumbales,  loins.  The  abdominal 
wall  is  here  thick  ;  the  peritoneum  is  firmly  attached  in  the  proxi- 
mity of  the  navel  to  the  linea  alba,  in  which  openings  for  vessels 
are  found,  especially  above  the  navel.  The  abdominal  wall  in  the 
region  of  the  loins  consists  of,  1.  Skin.  2.  Areolar  tissue  (fasc. 
superfic.)  in  a  thick  layer  between  m.  obliq.  extern,  and  longissim. 
dorsi;  passing,  below  the  twelfth  rib,  into  the  areolar  tissue  of  the 


446  TOPOGRAPHICAL  ANATOMY. 

thorax.  3.  M.  obliq.  externus  ;  behind  a  small  piece  of  latissim. 
dorsi.  4.  Fasc.  lumbo-dorsalis.  5.  M.  obliq.  internus,  covered 
before  by  m.  obliq.  extern.  6.  Areolar  tissue,  with  branches  of 
vasa  circumflexa  ilei  and  n.  ileo-hypogastric.  7.  M.  transversus. 
In  the  centre  of  the  space  between  navel  and  spina  ilei  ant.  supe- 
rior, one  is  equally  far  removed  from  artt.  epigastrica,  circumflexa 
ilei,  and  lumbales. 

In  the  abdomen  are  situated :  1.  The  great  omentum.  2.  Colon 
transversum  (separated  from  the  reg.  epigastrica  by  mesocolon 
transvers.) ;  the  small  intestines.  3.  Mesenterium.  At  the  sides, 
behind  some  of  the  convolutions  of  the  small  intestines :  1.  Colon 
ascend,  and  descendens.  2.  Kidneys  and  ureters  in  a  considerable 
quantity  of  adipose  tissue. 

698.  3.  Lumbar  regions,  regio  lumbalis,  lie  right  and  left  of 
the  fine  lumbar  vertebra?,  present  in  the  centre  a  groove  (with 
proc.  spinosi)  formed  by  the  projecting  mm.  ileo-lumbalis  and  Ion- 
giss.  dorsi;  are  bounded  below  by  crista  iliaca  and  spina  poste- 
rior.    Parts:    1.  Skin.     2.  Condensed   areolar  tissue.     3.  Fasc. 
lumbo-dorsal.  (posterior  layer).    4.  M.  ileo-lumbar.  and  longissim. 
dorsi.    5.  Fasc.  lumbo-dorsal.  (anterior  layer).     6.  M.  quadratus 
lumb.,  which  forms  the  most  posterior  portion  of  the  abdominal 
walls.     On  the  convex  anterior  surfaces  of  the  lumbar  vertebra  : 
1.  Crura  diaphragmatis ;  right,  ven.  cava ;   left,  aorta;  exter- 
nally,  nerv.  sympathicus  ;  above,  the  commencement  of  duct,  tho- 
racicus  and  of  ven.  azygos.     2.  Lymphatic  glands  and  areolar 
tissue,  which  are  connected  with  those  of  the  mesenterium.     Late- 
rally :  m.  psoas  ;  plexus  lumbalis  ;  and  2  to  3"  below  the  last  rib, 
the  kidneys,  in  adipose  tissue.     To  reach  the  abdominal  aorta  it 
is  not  necessary  to  open  the  peritoneum ;  between  m.  psoas,  quad- 
ratus lumborum,  and  peritoneum  we  find  areolar  with  abundance 
of  adipose  tissue. 

699.  4.  Inferior  abdominal  region,  regio  hypogastrica,  extends 
from  a  transverse  line,  between  the  two  spines  ilei,  as  far  down- 
wards as  the  bones  of  the  pubes. 

Parts:  1.  Skin  (with  pubic  hairs).  2.  Areolar  tissue  (fasc.  su- 
perfic.)  over  the  pubes,  thick  and  rich  in  adipose  tissue,  with  art. 
epigastric,  super/.  3.  M.  pyramidalis,  rectus  in  its  sheath  ;  lig. 
triangulare.  4.  Mm.  obliq.  and  transv.  5.  Fasc.  transv.,  be- 
longing to  the  inferior  fourth  of  m.  rectus,  immediately  adjacent  to 
which  is  the  peritoneum.  6.  Art.  and  ven.  epigastrica  ;  TJrachus  ; 
artt.  umbilicales  and  the  superior  third  of  the  urinary  bladder.  7. 


THE  TRUNK.  447 

Peritoneum.    In  the  abdominal  cavity :  the  small  intestines,  covered 
by  the  great  omentum. 

Lateral  parts,  inguinal  regions,  regg.  inguinales  (see  next  page). 

Iliac  fossa,  fossa  iliaca  internet,,  between  the  vertebral  column, 
the  crista  ilii  and  the  crural  arch  are  covered  by  m.  iliacus  and 
psoas.  Between  them  m.  cruralis  passes ;  transversely  behind  the 
psoas,  art.  iko-lumbalis  ;  before  it,  n.  genito  cruralis  ;  external  to 
it,  n.  inguino-cutaneus  ;  close  to  the  crista  iliaca,  the  art.  circum- 
flexa  ilei. 

Vasa  iliaca  commun.  and  hypogastrica  are  covered  by  lami- 
nated areolar  tissue  (fasc.  proprid},  and  by  : 

1 .  Fasc.  iliaca.  Upon  this  lie :  art.  iliaca,  in  the  direction  of 
a  line  between  the  navel  and  the  centre  of  the  crural  arch,  on  the 
anterior  and  outer  side  of  the  vein.  2.  Peritoneum.  3.  Ccecum 
on  the  right,  sigmoid flexure  of  colon  on  the  left,  &c.,  as  far  as  the 
external  skin.  The  fascia  iliaca  envelopes  the  psoas  above  by  its 
attachment  to  the  vertebral  column,  and  proceeds  below  the  crural 
arch  towards  the  trochanter  minor,  uniting  with  the  fascia  lata, 
(and  thus  forms  the  passage  which  the  pus  takes  in  psoas  abscess.) 

699.  bis.       Regio  inguinalis,  Inguinal  region, 
includes  the  parts  which  lie  the  breadth  of  two  fingers  above,  and 
the  breadth  of  three  fingers  below,  the  bend  of  the  thigh,  plica 
inguinalis. 

In  the  upper  part,  close  above  lig.  Fattopice,  lie  behind  the  skin : 

1.  Layers  of  fascia  super/.,  cutaneous  veins  between  them. 

2.  V.  super  fie.  abdom.,  5  to  f  "  distant  fromannitl.  abdom.;  ex- 
ternal to  it,  art.  epigastrica  superficialis. 

3.  Lig.  Fallopice  and  the  inferior  portion  of  the  tendon  of  m. 
obliq.  extern.  ;  with  annul,  abdom.  (l£"  removed  from  the  sym- 
pkys.  pubis),  and  canalis  inguinalis,  which  contains  the  spermatic 
cord  or  lig.  uteri  rotund.,  art.  sperm,  extern.,  ram.  intern,  of 
nerv.  spermat.  extern,  and  nerv.  ileo-inguinalis. 

4.  Behind  the  inguinal  canal  :  fasciculi  ofm.  obliq.  intern,  and 
transversus. 

5.  Fascia  transversalis  forms,  two  inches  distant  from  the  spina 
iliaca  anter.  super.,  the  annulus  inguinalis  (intern.}. 

6.  Fascia  propria  (areolar  tissue  between  fasc.  transversal,  and 
peritoneum),  with  vasa  epigastrica  (interna),  one  fourth  to  half  an 
inch  distant  from  the  internal  boundary  of  annul,  inguin.  (intern.). 

7.  Peritoneum  with  its  folds,  and  fovea  inguinal,  externa  and 
interna. 

At  the  inferior  part,  below  lig.  FaUvpia,  lie  behind  the  skin  : 


448  TOPOGRAPHICAL  ANATOMY. 

1.  Layers  offasc.  superf.  with  cutaneous  veins,  ram.  extern, 
nerv.  spermat.  externi,  ven.  saphena  magna  (and  superfic.  ab- 
domin.),  which  last  opens  one  inch  below  lig.  Fallop.'mto  the  vena 
cruralis,  surrounded  by  superficial  inguinal  glands,  outside  n. 
cutan.femor.  anter.  externus. 

2.  Superficial  layer  of  fascia  lata,  which  forms  proc.  falciform, 
andfovea  ovalis. 

3.  Vena  cruralis,  behind  fovea  ovalis  ;  externally  art.  cruralis 
behind  the  outer  part  of  proc.  falciform.  ;  on  the  outer  side  of  the 
artery,  nerv.  cruralis  in  its  sheath. 

4.  Upwards  towards  lig.  FalZopice :  the  crural  canal  and  crural 
ring  in  the  centre  between  spina  ilei  anter.  super,  and  symphysis 
pubis,  internal  to  and  below  the  internal  abdominal  ring. 

5.  Vasa  cruralia,  surrounded  by  the  deep  inguinal  glands,  en- 
closed by  the  vagina  vasorum,  separated  from  nerv.  cruralis  by 
the  deep  layer  offasc.  lota  ;  internally,  close  to  the  vessels,  the 
thin  prolongation  of *  fascia  transversalis  (septum  crurak,  Cloquet), 
and  lig.  Gimbernati ;  externally  m.  psoas  iliacus  with  nerv.  cru- 
ralis in  its  sheath. 

6.  Eminentia  ileo-pectincea,  and  ram.  horizontal,  oss.  pubis 
above  ;  m.  pectinceus  below  ;  behind,  the  deep  layer  offasc.  lata, 
covers  the  vasa  obturatoria,  at  their  exit  from  the  pelvis. 

The  triangular  space  between  lig.  Fallopice,  ram.  horizontal, 
pubis  and  os  ilium  filled  up  internally  by  lig.  Gimbernati,  in  the 
centre  by  the  vasa  cruralia  and  nerv.  cruralis,  externally,  by  the 
inferior  part  of  m.  psoas  iliacus  (between  spina  ilei  anter.  infer. 
and  eminent,  ileo-pectin.) 

[Dissection.  Above  Poupart's  ligament.  1.  Make  an  incision  through  the 
skin  only,  transverse  to  the  axis  of  the  body,  from  the  anterior  superior 
spinous  process  of  the  ilium  to  the  mesian  line  ;  from  the  termination  of  this, 
continue : 

2.  A  vertical  incision  to  the  symphysis  pubis.  Reflect  the  skin  towards 
the  thigh,  as  far  as  Poupart's  ligament.  Examine  the  layers  of  superficial 
fascia.  Reflect  them,  making  incisions,  as  before,  in  the  same  direction. 
Clear  away,  after  observing  it,  the  external  spermatic  fascia,  and  make  the 
boundaries  of  the  external  abdominal  ring  distinct.  Through  this,  in  the 
male,  the  spermatic  cord,  in  the  female,  the  round  ligament,  will  be  seen  to 
pass  ;  the  incision  may  be  extended  downwards,  following  the  course  of  these 
organs.  An  incision  should  now  be  made  through  the  tendon  of  the  external 
abdominal  oblique  muscle  only,  in  a  direction  corresponding  with  No.  1, 
above,  and  the  tendon  reflected  towards  the  thigh,  the  fibres  connecting  it 
with  the  subjacent  tendons,  and  the  tendon  of  the  muscle  of  the  opposite  side 


THE  TRUNK.  449 

(the  decussating  fibres),  being  carefully  divided.  Examine  next  the  free 
muscular  edge  of  the  internal  oblique  and  transversalis  muscles,  and  their  con- 
joined tendons,  as  well  as  the  fibres  of  the  cremaster  muscle  in  the  male.  From 
the  junction  of  the  outer  with  the  middle  third  of  Poupart's  ligament  carry 
an  incision  vertically  upwards,  parallel  with  the  linea  alba,  dividing  and  re- 
flecting inwards  in  succession,  and  outwards,  the  muscular  fibres  of  internal 
oblique  and  transversalis  muscles.  The  muscular  fibres  must  be  detached 
from  the  outer  third  of  Poupart's  ligament.  From  the  commencement  of  the 
vertical  incision  the  fibres  may  be  separated  in  the  direction  of  their  fasciculi, 
namely,  towards  linea  semilunaris.  The  fascia  transversalis  will  now  be 
exposed,  the  spermatic  cord  (or  round  ligament)  resting  upon  its  pubic  portion, 
and  lost  in  the  internal  abdominal  ring,  the  external  or  iliac  portion  attached 
to  Poupari1 s  ligament.  The  fascia  spermatica  interna  is  to  be  examined, 
and  then  removed,  to  display  more  clearly  the  margins  of  the  ring.  Next 
push  upwards  and  backwards  the  peritonaeum,  and  observe  the  course  of  the 
spermatic  vessels,  the  vas  deferens,  and  the  relations  of  the  external  iliac  and 
internal  epigastric  arteries.  The  fascia  iliaca  and  its  attachments  may  like- 
wise be  studied. 

Below  Poupart's  ligament.  1.  Make  an  incision  from  the  anterior  and 
superior  spinous  process  of  the  ilium  to  the  centre  of  the  thigh,  the  direction 
being  inwards ;  in  fact,  parallel  with  the  course  of  the  fibres  of  the  Sartorius 
muscle. 

2.  An  incision  from  the  spine  of  the  pubes,  downwards,  to  the  termination 
of  the  last.  Reflect  the  skin,  only,  upwards.  Fat  and  fibro- cellular  tissue 
forming  more  or  less  a  superficial  fascia,  which  encloses  small  arteries  and 
veins,  lymphatics,  and  their  glands  above,  and  the  saphena  vein  below,  may 
be  reflected  upwards.  The  fascia  lata  will  be  exposed,  and  immediately 
below  the  point  at  which  the  saphena  vein  is  lost  to  view,  by  entering  the 
sheath  of  the  femoral  vessels,  it  divides  into  an  internal  pubic  and  an  external 
iliac  portion.  The  handle  of  the  scalpel  may  be  passed  under  the  falciform 
process  of  the  latter,  and  upon  raising  it,  the  sheath  of  the  femoral  vessels  is 
seen.  The  lymphatic  vessels  may  be  seen  passing  under  Poupart's,  and  close 
to  the  outer  border  of  Gimbernat's  ligament,  on  the  inside  of  the  femoral 
vein,  to  the  outer  side  of  which  is  the  femoral  artery,  each  enclosed  in  sepa- 
rate fascial  canals,  the  most  internal  being  called  the  crural  ring.  To  demon- 
strate this,  make  a  small  longitudinal  incision  through  the  anterior  surface  of 
the  sheath,  parallel  to  and  over  the  centre  of  each  vessel ;  then,  with  the 
handle  of  the  scalpel  passed  along  the  sides  of  vessels,  raise  them  from  their 
fibrous  canals.  A  considerable  quantity  of  adipose  tissue  will  be  found  sur- 
rounding the  lymphatics  below  and  at  their  entrance  into  the  crural  ring. 
Dividing  carefully  across,  or  detaching  the  posterior  surface  of  Poupart's  liga- 
ment from  the  anterior  of  the  sheath  of  the  femoral  vessels  (septum  crurale), 
the  connexion  bet  ween  this  sheath  and  the  pubic  portion  of  fascia  transversalis 
will  be  displayed.  TRANS.] 

29 


450  TOPOGRAPHICAL  ANATOMY. 


Pelvis. 

700.  I.  Pubic  region,  regio  pubis  (see  parts  of  generation). 

Cavity  of  the  small  pelvis.  Behind  the  symphysis  pubis  : 
1.  Urinary  bladder.  2.  Vas  deferens  and  ureter  upon  both 
sides  (they  cross  each  other).  3.  Fossa  recto-vesicalis  in  the  male, 
vesico-uterina  in  the  female.  4.  In  the  female :  Uterus,  vagina, 
and  broad  ligaments  (they  divide  the  pelvis  into  an  anterior  and  a 
posterior  half) ;  behind  that  fossa  recto-uterina.  5.  Behind  and 
to  the  left,  rectum,  fixed  above  by  meso-rectum,  below  by  loose 
areolar  tissue. 

701.  II.  Perinoeal  region,  R.  perincei, 

closes  the  pelvic  outlet,  is  bounded  behind  by  the  coccyx,  on  the  side 
by  ligg.  sacro-ischiatica,  tuber  and  ram.  ascendens  ischii,  in  part, 
by  ligg.pubicum  inferius  ;  below,  by  the  external  skin,  above,  by 
the  peritoneum.  It  is  oval,  passes  forwards  towards  the  root  of 
the  penis  (or  the  commissura poster \  labior.pudend.),  and  is  divided 
by  a  transverse  line  extending  between  the  two  tuberosities  of  the 
ischia,  into  the  anterior,  proper  perineeal,  and  into  the  anal  region. 

1.  Reg.  analis,  region  of  the  anus. 

a.  At  the  sides  of  the  anus:   1.  The  skin.     2.  Much  areola, 
containing  adipose  tissue  with  vasa  and  nn.  hcemorrhoidal.  inferr. 
3.  Fasc.  perincei.     4.  M.  levator  and  sphincter  ani.     5.  Fascia 
pelvis .     6.  Peritoneum. 

b.  Behind  the  anus  :  skin,  condensed  areolar  tissue,  containing 
adipose,  posterior  extremity  of  sphincter  ani,  fascia  perin.,  mm. 
levatores  in  the  raphe,  fascia  perin.  superior,  fat  and  areolar  tissue, 
coccyx,  and  sacrum. 

2.  Reg.  perincealis  s.uro-genitalis^he  anterior  triangular  part  of 
the  perineum,  between  the  pubic  arch  and  a  transverse  line  between 
the  two  tuber  a  ischii. 

a.  In  the  male  :  1.  Skin,  wrinkled,  thin,  hairy.  2.  Loose  lami- 
nated areolar  tissue  with  adipose,  which  continues  on  to  the  scrotum. 
3.  Fascia  superjicialis  with  the  vasa  and  nn.  perincei  superfic.  (in 
the  direction  of  tuber  ischii  of  the  one  to  the  spina  pubi,s  of  the 
other  side.)  M.  bulbo-cavernos.  in  the  centre,  transvers.  and  ischio- 
cavernosi  on  the  sides.  5.  Bulbus  urethrce  in  the  centre,  corp.  ca- 
vernos.  on  the  sides ;  in  the  triangular  space  between  the  two,  two 
or  three  lines  from  the  ram.  ascend,  ischii,  crosses  art.  transvers. 
perincei ;  4.  and  5.  lie  in  a  sheath  formed  offasc.  superjic.  and 
profunda  s.  media.  6.  Lig.  perinceale  ;  it  is  perforated  by  bulb, 
urethra  and  vasa,  nn.  dorsal,  penis  (between  corp.  cavcrnos.  and 


THE  TRUNK.  451 

ram.  descend,  pubis).     7.  Between  fascia  perinsei  and  pelvis  lie 
from  before  to  behind  : 

a.  Pars  membranacea  urethra  with  Cowper's  glands  and  in- 
vested behind  by  mm.  bulbo-cavernosus. 

b.  Prostata,  pars  prostat.  urethra  and  collum  vesica,  attached 
above  by  lig.  pubo-prostaticum  (six  to  eight  lines  behind  the  sym- 
physis  pubis,  two  or  three  above  the  anus). 

c.  Vesiculce  seminales,  and  vasa  deferentia  between  them,  and 
crossing  with  the  inferior  extremity  of  the  ureters.     In  the  tri- 
angular space  between  them  the  fundus  vesica  rests  upon  the  rec- 
tum ;  between  the  last  the  neck  of  the  bladder,  prostatic  and  mem- 
branous  portion  of  the  urethra?,  a  triangular  space  also  exists 
(which  is  taken  advantage  of  in  Lithotomy). 

8.  Anterior  portion  offasc.  pelvis  (forms  a  sheath  for  the  pro- 
stata  and  plex.  venosus  prostaticus).  9.  Laminated  areolar  tissue. 
10.  Peritoneum. 

b.  In  the  female  the  proper  perineum,  that  is,  the  region  between 
the  labia.  majora  and  orific.  ani.  is  shorter  (fifteen  lines  long),  but 
broader  than  in  the  male.  Fascia  perinai,  very  strong ;  the 
muscles  are  the  same,  only  instead  of  bulbo-cavernosus  the  con- 
strictor vagina. 

The  urethra  (one  to  an  inch  and  a  half  long,  before,  four  to 
six  lines,  behind,  three  lines  broad),  passes  backwards  beneath  the 
pubic  arch  on  the  anterior  surface  of  the  vagina  curved  rather  up- 
wards. Its  orifice  lies  a  quarter  of  an  inch  below  the  clitoris. 

The  vagina  (four  inches  long,  one  inch  broad)  curved,  ascends, 
backwards,  between  urethra,  bladder,  and  rectum  ;  between  their 
openings  and  that  of  the  last  a  triangular  space  exists  (the  base  of 
which  lies  below,  since  the  vagina  and  rectum  lie  close  upon  one 
another,  fifteen  lines  above  the  orific.  ani.),  in  which  adipose  as 
well  as  areolar  tissue,  fibres  of  mm.  transvers.,  sphincter,  levator 
ani,  constrictor  vagina,  and  the  vasa  transvers.  perinai  are  found. 
To  their  sides  fascia  pelvis  is  firmly  attached. 

The  triangular  space  of  the  vestibule  between  the  clitoris  and  the 
orificium  urethra  is  taken  advantage  of  in  Lithotomy ;  in  it  we 
find  :  1.  The  mucous  membrane.  2.  Very  vascular  areolar  tissue 
in  the  centre,  the  roots  of  the  clitoris  covered  by  the  mm.  ischio- 
cavern.  and  the  anterior  extremity  of  sphincter  vagina  on  the 
sides.  3.  Fascia  perinai  (with  the  art.  transvers.  perinai)  per- 
forated by  the  urethra.  4.  Vv.  dorsaks  clitorid.,  collum  vesica 
and  ligg.  pubo-vesicalia.  5.  The  inferior  portion  of  the  anterior 
wall  of  the  bladder. 


452  TOPOGRAPHICAL  ANATOMY. 

The  urinary  bladder  lies,  in  the  female,  higher  over  the  perinseum, 
than  in  the  male. 

The  orificium  ani  is  broader,  and  is  placed  more  posteriorly 
(behind  a  transverse  line  between  the  tuber  ischii)  than  in  the  male. 

[Dissection.     1.  Of  the  male  perinaeum. 

The  subject  should  be  tied  up',  as  in'the  operation  for  lithotomy.  The  bony 
boundaries  of  the  perinaeal  region  must  then  be  carefully  recognised. 

Incisions  through  the  skin :  1.  A  vertical  incision  is  to  be  made  in  the  raphe 
from  the  arch  of  the  pubes,  which  may  be  felt,  or  from  the  junction  of  the 
skin  of  the  perinaeum  with  that  of  the  scrotum,  to  the  anterior  verge  of  the 
anus.  2.  Transverse  incisions,  one  on  either  side  from  the  termination  of  the 
last  to  the  outer  sides  of  the  tubera  ischii.  The  two  triangular  flaps  thus 
formed  are  to  be  reflected  outwards  over  the  thighs,  and  there  fastened.  3. 
From  the  anterior  verge  of  the  anus  carry  two  incisions,  one  on  either  side, 
around  the  opening,  backwards,  until  they  meet  at  the  posterior  verge  in  the 
middle  line  behind  ;  from  this  point  continue  directly  downwards  to  the  coc- 
cyx. These  two  likewise  triangular  flaps  are  to  be  reflected  over  the  thighs, 
and  there  secured.  The  sphincter  ani  is  now  to  be  dissected,  and  after  exa- 
mining the  posterior  portion  of  the  superficial  fascia,  the  ischiorectalfossce  of 
either  side  may  be  cleaned  out. 

Continuing  the  dissection  of  the  perinaeum,  make  an  incision  in  the  middle 
line  as  before  indicated,  from  the  arch  of  the  pubes,  in  front,  to  the  anterior 
extremity  of  anus,  behind,  having  previously  reflected  the  superficial  anterior 
fibres  of  the  sphincter  ani,  or  even  dividing  them  also  in  the  centre.  Now, 
carefully  dissecting  the  superficial  fascia  away  from  its  posterior  or  deeper 
connexions,  examine  its  relations  with  the  deep  perinaeal  fascia  behind. 
Having  done  this,  divide  the  junctions  between  them,  and  reflect  the  layers 
of  the  superficial  fascia  on  either  side,  observing  their  attachments  to  the  an- 
terior borders  of  the  rami  of  the  ischia  and  pubes. 

Care  must  be  taken  of  the  perinaeal  vessels  and  nerves  which  traverse  this 
fascia.  The  muscles  of  the  perinaeum  may  now  be  dissected. 

The  accelerator  urines  should  be  detached  from  the  deep  fascia  behind,  for 
it  does  not  arise  from  it,  but  is  merely  applied  to  its  anterior  surface.  With  a 
little  care  and  dexterity,  the  handle  of  the  scalpel  may  be  gradually  passed 
between  the  muscle  and  the  spongy  body  which  it  surrounds.  The  tubular 
character  of  the  muscle  is  then  clearly  demonstrated.  The  posterior  portion 
of  the  corp.  spongiosum  and  urethra  may  even  be  divided  transversely,  and 
then  withdrawn  from  the  muscular  tube. 

2.  Of  the  female  perinaeum. 

The  vertical  incision  should  be  carried  to  the  anterior  commissure  of  the 
vagina,  and  then  round  the  borders  of  its  mouth,  meeting  at  the  posterior 
commissure,  terminating  in  front  of  the  anns.  With  this  variation  excepted, 
as  in  the  male.  TRANS.] 


THE  TRUNK.  453 

702.  Axillary  cavity,  fovea  axillaris,  Axilla, 

is  triangular;  its  base  directed  towards  the  chest,  its  apex  towards 
the  inner  side  of  the  upper  arm,  its  anterior  wall  is  formed  by  m. 
pectoralis  major ,  minor,  and  the  anterior  portion  of  the  deltoideus  ; 
its  posterior  wall  by  m.  latissimus  dorsi,  teres  major,  and  subscapu- 
laris  ;  the  inner  wall  by  m.  serratus  magnus  and  the  chest ;  the 
external  wall  by  m.  biceps,  coraco-brachial.,  upper  arm  (the  upper- 
most part).  The  blunt  apex  forms  a  triangular  opening,  which  is 
in  connexion  with  the  reg.  supraclavicularis  ;  formed  in  front  by 
the  clavicula,  behind  by  the  superior  border  of  reg.  scapularis,  in- 
ternally and  below  by  the  first  rib. 

703.  Fossa  infraclavicularis, 

is  the  name  given  to  a  triangular  excavation  on  the  anterior  wall 
of  the  axilla,  through  which  we  pass  to  the  apex  of  that  fossa.  It 
is  bounded  externally  by  the  head  of  the  humerus  ;  internally,  by 
proc.  coracoid. ;  above,  by  clavicula  and  acromion  ;  and  arises  from 
the  fissure  between  m.  deltoid,  and  pectoralis  major.  Before  it 
pass  vena  cephalica  and  art.  acromialis.  Behind  that  vasa  and 
nn.  thoracici  externi  ;  m.  pectoralis  minor  and  fasc.  coraco-clavi- 
cularis,  m.  subclavius.  Beneath  the  hairy  and  thin  skin  at  the  base 
of  the  axilla,  which  is  largely  supplied  with  sebaceous  follicles,  a 
loose  adipose  areolar  tissue  is  found,  some  superficial  lymphatic 
glands,  fasc.  brachialis  (between  m.  pectoral,  maj.  and  latissim. 
dorsi),  branches  of  vasa  axillar.  and  the  v.  axillaris,  deep  lym- 
phatic glands,  vena  and  art.  axillaris,  the  trunks  of  nerves,  lami- 
nated areolar  tissue,  and  the  shoulder  joint. 

Art.  axillaris  passes  :  a.  between  the  first  rib  and  the  superior 
border  of  m.  pectoral,  minor,  on  the  outer  side  of  v.  axillaris,  on  the 
inner  of  the  inferior  branch  of  piece,  nerv.  brachialis  and  proc.  cora- 
coid.,  supported  upon  m.  intercostal.  I.,  the  second  rib,  and  m.  serrat. 
antic,  major. ;  b.  behind  pectoralis  minor,  covered  by  the  two  roots 
of  the  n.  medianus  before,  closer  to  the  humerus  ;  c.  from  the  infe- 
rior external  border  of  m. pectoral,  minor,  as  far  as  to  the  inferior 
limit  of  the  axilla,  behind  v.  axillar.,  internal  to  and  behind  nerv. 
medianus,  m.  coraco-brachial.,  cap.  breve  bicip.,  and  os  humeri ; 
before  nerv.  ulnaris,  before  and  internal  ton.  radialisand  oxittaris. 
Behind  implex,  lymphaticus,  tendons  of  subscapularis, m.  latissim. 
dor  si.  The  direction  of  art.  ven.  axillaris,  and  the  pkx.  brachialis, 
is  oblique  from  above  and  within,  to  below  and  without  (from  the 
anterior  internal  angle  of  the  axilla  to  its  external). 


454  TOPOGRAPHICAL  ANATOMY. 

On  the  costal  parietes  pass  ;  art.  mammaria  externa  (in  front), 
n.  thoracic,  poster,  (behind)  and  nn.  cutanei  brachii. 

On  the  posterior  wall  of  the  axilla :  a  branch  of  art.  scapular, 
commun.,  a  nerv.  infrascapular .,  and  lymphatics. 

The  largest  number  of  lymphatic  glands  lie  at  the  internal  ante- 
rior angle  above  the  mm.  pectorales,  and  close  to  the  axillary  bor- 
der of  the  scapula. 


The  Extremities. 

704.  Plica  cubiti,  bend  of  the  elbow, 

is  the  angle  in  the  anterior  region  of  the  elbow,  which  the  articular 
ends  of  the  upper  and  forearm  form  with  one  another.  We  there 
find  under  the  skin  and  fascia,  which  above  passes  into  the  f.  bra- 
chii, below  into  the  vagina  cubiti,  the  fossa  cubiti,  a  triangular  de- 
pression bounded  externally  by  m.  supinator  longus,  internally  by 
pronator  teres,  at  the  base  by  the  tendon  of  the  biceps,  and  m. 
brachialis  internus  (above),  the  origin  of  flexores  commun.  digit. 
and  supinat.  brevis  (below).  Position  of  the  parts  in  the  fossa 
cubiti : — 

1.  Yen.  mediana.  2.  Aponeurosis  bicipitis.  3.  Art.  brachialis 
between  its  veins.  4.  Nerv.  medianus  on  the  inner.  5.  Tendon 
of  biceps  on  the  outer  side  of  the  artery. 

705.  Fossa  poplitcea,  bend  of  the  knee, 

a  rhomboidal  shaped  space  on  the  posterior  (flexion)  side  of  the 
knee,  is  formed  below  by  the  two  heads  of  m.  gastrocnemius,  the 
inner  of  which  is  the  longer,  and  partly  covered  by  the  tendon  of 
semimembranosus  ;  the  external  superior  side  by  the  biceps,  the 
internal  by  the  belly  of  semimembranosus,  then  by  the  tendons  of 
the  last-named  muscle,  the  sermtendinosus,  gracilis,  and  sartorius. 

Position  of  the  parts  :  1.  Skin  thin,  smooth,  and  very  extensi- 
ble. 2.  Fibro-cellular  tissue  with  adipose,  in  which  cutaneous  veins 
and  the  terminal  branches  of  nerv.  cutaneus  femor .  poster,  magn. 
and  nerv.  cutan.  post,  medius.  3.  Fascia  lata ;  forming,  with  a 
superficial  layer,  an  arch  over  the  fossa,  covers  with  a  deep  layer 
the  limits  and  the  floor  of  it ;  surrounding  also,  besides  lymphatic 
glands,  fibro-cellular  and  adipose  tissue,  the  vessels  and  nerves. 

a.  Art.  poplitcza,  passes  pretty  nearly  in  the  centre  of  the  fossa, 


THE  TRUNK.  455 

is  entirely  covered  above  by  ven.  poplitaa,  fibro-cellular  tissue, 
fascia,  and  skin,  at  the  lowest  part  by  m.  gastrocnem.^  and  the  ob- 
liquely passing  m.  plantaris. 

b.  Ven.  poplitcea,  firmly  adherent  to  the  posterior  external  side 
of  the  artery. 

c.  Nerv.  tibiaHs,  to  the  posterior  external  side  of  the  vein,  pass- 
ing  away  obliquely  behind  it  to  the  inner  side. 


456 


TOPOGRAPHICAL  ANATOMY. 

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458  TOPOGRAPHICAL  ANATOMY. 

d.  Nerv.  peronaus,  on  the  inner  side  of  m.  biceps,  covered  only 
by  fascia,  on  the  posterior  surface  of  condyl.  extern,  femor.  to  the 
outer  side  of  condyl.  extern,  tibia,  as  far  as  behind  capltul.  fibula. 

The  two  nerves  (c  and  d)  receive  the  art.  and  vein  in  the  centre 
between  them. 

4.  M.  poplitceus,  5.  Ligam.  poplitceum,  pass  obliquely  down- 
wards from  condyl.  extern,  femoris  to  condyl.  intern,  tibice.  6. 
Fossa  condylorum  posterior  of  the  knee  joint. 

Situation  of  the  Viscera,  relative  Position  of  the  Organs  in 
the  Three  Great  Cavities. 

708.  Cranial  Cavity. 

After  removing  the  cranial  bones  we  directly  come  to 
I.  Dura  mater,  from  the  internal  surface  of  wliich  the  follow- 
ing processes  pass  between  the  recesses  of  the  brain  : — 

1.  Proc.falcifarmis  major,  s.falx  cerebri.     Its  superior  convex 
border  extends  from  foram.  ccecum  and  crista  galli  of  ethmoid 
bone  along  the  crista  frontal,  interna,  beneath  the  central  line  of 
the  cranial  arch  as  far  as  protuberant,  occipital,  interna  ;  contain- 
ing the  sinus  longitudinal,  superior.     Its  inferior  concave  border 
is  extended  freely  between  the  two  hemispheres  of  the  cerebrum, 
close  above  the  corp.  callosum  in  the  scissura  longitudinal,  cerebri; 
it  contains  the  sinus  longit.  inferior. 

2.  Tentorium  cerebelli  ;  lies  over  the  fossa  cranii  inferior,  trans- 
versely between  the  lobes  of  the  cerebrum  and  the  superior  surface 
of  the  cerebellum,  below  the  falx  cerebri  and  above  thefalx  cerebelli. 
In  the  middle  line  passes  sinus  quartus  [straight  or  horizontal 
sinus].  Its  external  convex  border  is  attached  to  the  linea  cruciatce, 
transversce  occipitis,  the  angulus  super,  oss.  petrosi,  as  far  as  the 
proc.  clinoidei poster.;  contains  sinus  transvers.  and  petrosi  supe- 
riores.     Its  free,   internal,  concave  border  reaches  as  far  as  the 
corp.  quadrigemina,  splenium  corp.  callosum  and  pons  Varolii. 

3.  Process,  fakiformis  minor  s.falx  cerebelli  lies  in  theincisura 
cerebelli  poster.,  between   the  hemisphcer.  cerebelli,  behind   tuber 
valvul.  and  pyramis  vermis,  beneath  the  centre  of  the  Tentorium, 
and  extends  along  the  crista  occipital,  interna  from  the  protuberan- 
tia  as  far  as  foram.  magnum  ;  containing,  at  the  posterior  attached 
border,  sinus  occipitalis  posterior. 

4.  Process,  spurii  dura  matris  are  visible  after  the  brain  is  re- 
moved from  the  skull. 

a.  Roof  of  the  sella  turcica,  stretched  between  proc.  clinoid. 


THE  EXTREMITIES.  459 

anter.  and  poster.,  covers  the  fossa  pro  gland,  pituitar.,  presenting 
in  the  middle  a  foramen  for  infundibul.  and  sin.  circular  Ridkyi. 

b.  Between  the  apex  of  the  petrous  and  the  alaparva  of  sphe- 
noid bone,  the  superior  external  wall  of  sin.  cavernos.,  and  farther 
outwards  the  sin.  ophthalmicus  is  formed. 

c.  Tubular  sheaths  for  vessels  and  nerves  penetrate  the  fora- 
mina of  the  basis  cranii. 

5.  Sinus  ;  are  found  between  the  layers  of  the  dura  mater. 

a.  Sinus  transversi  in  the  sulcus  transvers.,  at  the  posterior 
border  of  tentorium  cerebetti.     Into  it  open 

1.  Sinus  longitud.  super.;  passing  along  the  convex  border  of 
falx  cerebri ;  opens  into    the  right  sin.  transv.  on  the  protube- 
rantia  occipit.  interna. 

2.  Sinus  quartus  /  [straight]  passes  into  the  centre  of  tento- 
rium, from  before  backwards ;  receiving  where  tentorium  and  falx 
cerebri  unite, 

Vena  magna  Galeni,  which,  arising  by  the  confluence  of  vv. 
cerebrales  internee,  pass  into  plexus  choroid.  3. 

Its  posterior  extremity  enters  the  left  sinus,  transversus  (s.  tor- 
cular.  Herophili). 

3.  Sinus  longitud.  inferior,  on  the  concave  border  of  falx  cere- 
bri,  passes  into  sinus  quartus. 

4.  Sinus  petrosus  superior,  in  the  sulcus  petrosus  on  the  supe- 
rior angle  of  pars,  petrosa ;  unites  sinus  cavernos.  with  trans- 
versus. 

5.  Sinus  petrosus  infer.,  between  the  apex  of  pars  petrosa  and 
the  clivus ;  opens  at  the  foram.  jugulare  into  the  sinus  trans- 
versus. 

b.  Sinus  occipitalis  posterior  passes  on  the  crista  occipit.  in- 
terna, from  the  torcular  Herophili  downwards  to  the  sinus  circu- 
lar, foram.  magni,  which  lies  upon  the  posterior  boundary  of 

foram.  magn.,  and  is  connected  with  the  so-called  sin.  occipit.  ant. 
s.  basilar.  upon  the  clivus  and  ihe  fossa  pro  medulla  oblongata. 

c.  Sinus  cavernosi  passes  on  both  sides  of  sella  turcica  between 
the  apex  of  petrous  and  alaparva  of  sphenoid  bone.     Into  it  dis- 
charge, 

1 .  Sinus  circularis  Ridkyi  ;  surrounding  the  hypophysis  ce- 
rebri. 

2.  Sinus  spheno-parietales  s.  ophthalmici  (ant.  extremity  of  sin. 
cavernosi) ;  at  the  inferior  extremity  of  fiss.  orbitalis  superior. 

3.  Sinus  petrosi  anteriores  ;  between  pars  squamosa  and  pe- 
trosa of  temporal  bone  (often  wanting). 

II.  Arachnoidea,  surrounded  by  the  Dura,  it  surrounds  the  pia 


460  TOPOGRAPHICAL  ANATOMY. 

mater  ;  it  is  extended  like  a  bridge  across  all  the  depressions,  and 
over  all  the  sulci  of  the  brain. 

III.  Pia  mater,  slightly  attached  to  the  free  surface  of  the  brain, 
and  entering  into  all  its  suki,  depressions  and  cavities,  it  closes  the 
fourth  ventricle  at  the  Jissur.  transv.  cerebelli,  [abnormally]  and 
the  third  ventricle  even  at  the  foram.  Bichat.  in  the  Jiss.  transv. 
cerebri. 

709.  IV.  Cerebrum,  great  brain.     Its  superior  convex  surface 
looks  towards  the  cranial  vault,  and  is  divided  into  two  hemispheres 
by  the 

Scissura  longitudinalis,  which  penetrates  as  far  as  corpus  cal> 
losum,  in  front,  before  the  genu  corpor.  callosi,  and  between  the 
anterior  cerebral  lobes  to  the  base  of  the  skull ;  behind,  posterior 
to  splenium  corp.  callosum,  and  between  the  posterior  cerebral 
lobes  to  the  cerebellum,  and  receives  ihefalx  cerebri. 

Anterior  cerebral  lobes.  Their  inferior  surfaces  lie  upon  the 
fossa  cranii  anterior ;  their  internal  surfaces  meet  together ;  be- 
hind they  are  separated  from  the  middle  lobes  by  the  fossa  Sylvii. 
On  the  inferior  surface,  towards  their  inner  border,  the  sulcus  trac- 
tus  olfactorii  is  seen,  at  the  posterior  termination  of  which,  close 
before  substantia  perfor.  media,  lie  the  corp.  mammillaria. 

Middle  cerebral  lobes  are  indistinctly  bounded  behind  by  margo 
petrosus  of  petrous  bone,  and  they  occupy  the  fossce  cranii  media. 

Posterior  cerebral  lobes  occupy  the  space  in  thefossce  occipitales 
superiores.  Between  them  and  the  cerebellum  the  Jissura  transv. 
cerebri  leads  to  splen.  corp.  callos.,  corp.  quadrigem.,  ventricul. 
3.,  and  later  ales. 

710.  V.  Cerebellum,  lesser  brain,  fills  up  the  fossce  occipitales 
inferiores,  is  divided  by  the  horse-shoe-shaped  incisur a  poster.,  at 
the  posterior  border  and  falx  cerebelli,  into  two  hemispheres,  by  a 
deep  transverse  groove,  sulcus  horizontalis  Reilii,  into  a  superior 
and  inferior  hal£  united  in  the  middle  line  by  the  vermis  [proc. 
vermiformis'].    The  vallecula  on  the  inferior  surface  of  the  vermis 
receives  anteriorly  the  pons  Varolii,  behind  the  medulla  oblongata. 
Between  the  last  and  the  cerebellum  the  Jissura  transversa  cere- 
belli leads  into  the  fourth  ventricle.     The  superior  surface  of  the 
cerebellum  is  separated  from  the  posterior  lobes  of  the  cerebrum 
by  the  tentorium. 

711.  VI.  Basis  encephali.     We  find  in  the  middle  line  from 
behind  to  before, 


SITUS  VISCERUM.  461 

1.  Medulla  oblongata.  upon  the  pars  basilar.  occipitis,  between 
the   hemispheria  cerebetti,  behind  pons  Varolii.     In  its  middle 
line : 

a.  Fissura  long,  anterior  ;  on  the  side  of  this : 

b.  Corp.  pyramidalia.     Next  to  these  the  olivary  bodies, 
and  most  posteriorly  and  externally  the  corp.  restiformia. 

2.  Pons  Varolii,  upon  the  clivus,  behind  the  crura  cerebri,  be- 
tween the  crura  cerebelli  ad  pontem. 

3.  Substantia  perforata  media,  between  crura  cerebri. 

4.  Corp.  mammiUaria,  above^?r0c.  clinoidei  posterior es,  between 
crura  cerebri. 

5.  Tuber  cinereum,  between  the  anterior  extremities  of  tractus 
optici,  elongating  itself  forwards  and  downwards  in  the  infundibu- 
lum  to  the  hypophysis  in  the  sella  turcica. 

6.  Chiasma  nerv.  opticorum,  upon  the  proc.  clinoidei  medii, 
between  the  two  lamina  cribrosce,  which  lie  before  the  crura  cere- 
bri at  the  commencement  offossce  Sylvii,  and  the  posterior  extre- 
mity of  sulcus  tractus  olfactorius.     On  the  sides  of  the  base  are 
situated, 

1.  Fossa  Sylvii,  with  the  insula  of  Reil,  and  the  oper- 
culum. 

2.  Crura  s.  pedunculi  cerebri,  behind  the  tractus  opticus, 
before  pons  Varolii. 

3.  Tractus  opticus,  behind  lamina  cribrosa,  before  crus 
cerebri,  winding  round  them. 

4.  Gyrus  hippocampi,  externally  close  to  crus  cerebri, 
forms  in  front  the  uncus. 

712.  VII.  Cerebral  nerves. 

1.  Olfactorius,  appears  at  the  internal  extremity  of  fossa  Sylvii 
and  lamina  cribrosa,  passes  in  the  sulcus  tractus  olfactorius  on 
the  inferior  surface  of  the  anterior  cerebral  lobes,  enlarges  (bulbus 
cinereus)  upon  the  cribriform  plate  of  the  ethmoid  bone,  and  quits 
the  cranial  cavity  with  a  double  series  of  filaments. 

2.  Opticus,  appears  at  the  anterior  border  of  chiasma,  passes 
through  foram.  opticum,  where  it  lies  above  and  internal  to  art. 
ophthalm.,  into  the  orbit,  where  it  is  situated  on  the  outside  and 
below  it. 

3.  Oculo-motorius,  appears  on  the  inside  of  the  pedunc.  cerebri, 
passes  through  a  fissure  of  the  dura  mater,  approaching  proc.  cli- 
noid.  post.,  into  the  sinus  cavernosus,  along  the  superior  wall,  out- 
side the  carotis  interna  ;  enters  the  orbit  th rough  fissura  orbital, 
superior. 


462  TOPOGRAPHICAL  ANATOMY. 

4.  Trochkaris,  appears  at  the  anterior  lateral  border  of  pons 
Varolii,  before  the  cms  cerebelli  ad  pontem,  perforates  the  dura 
mater  behind  proc.  clinoid.  post.,  passes  in  a  canal  formed  by  it 
above  the  apex  of  the  petrous  bone,  between  the  superior  and  outer 
wall  of  sinus  cavernosus,  to  the  Jiss.  orbital,  super.,  and  into  the 
orbit. 

5.  Trigeminus,  appears  at  the  anterior  lateral  border  of  pons 
Varolii,  before  the  crura  cerebelli  ad  pontem,  external  to  troch- 
learis,  penetrates  the  anterior  border  of  tentorium  close  above  the 
apex  of  the  petrous  bone,  and  there  forms  the  ganglion  Gasseri, 
from  the  inferior  border  of  which  its  first,  second,  and  a  portion  of 
its  third  division  pass  off. 

Ramus  I.  passes  through  fissura  orb.  superior. 

—  II.  through  for  am.  rotundum. 

—  III.  through  foram.  ovale  out  of  the  skull. 

6.  Abducens,  appears  between  the  posterior  border  of  pons  Va- 
rolii  and  the  corp.  pyramid.,  enters  through  the  fissure  of  the  dura 
mater,  on  the  clivus,  into  the  sinus  caver nos.,  and  passes,  when  in 
this,  on  the  outer  side  of  the  carotis  to  thejfiss.  orbital,  superior. 

7.  Facialis,  appears  at  the  posterior  lateral  border  of  pons  Va- 
rolii,  between  crus  cerebelli  ad  pont.  and  corp.  restiforme,  passes 
in  a  sulcus  of  the  acusticus;  and  enters,  by  the  meatus  auditor,  in- 
tern., into  the  canal  FaUopice. 

8.  Acusticus,  appears  externally  close  to  the  last,  passes  to 
meatus  auditor,  intern,  between  corp.  olivare,  floccul.,  and  crus 
cerebelli  ad  pontem. 

9  and  10.  Glosso-pharyngeus  and  vagus,  appear  below  the  pos- 
terior border  of  pons  Varolii,  between  corp.  olivare  and  restiforme, 
they  pass  out  through foram.  jugulare  [post,  lacerated  foramen]. 

11.  Accessorius  Willisii,  passes  through  for.  magnum  into  the 
cranium,  and  leaves  it  through  foram.  jugulare  [post,  lacerated 
foramen]. 

12.  Hypoglossus,  appears  between  corp.  olivare  and  pyramid., 
passes  out  through  foram.  condyloid.  anterius. 

713.  VIII.  Arteries  [see  §  552,  and  554.] 

1.  Carotis  cerebralis,  enters  the  sinus  cavernosus  at  the  apex  of 
the  petrous  bone,  surrounded  by  plexus  carotic.  intern.,  lies  upon 
the  outer  inferior  side  of  the  sinus,  penetrates  it  behind  foram. 
opticum,  gives  off  art.  ophthalmica,  and  divides  into  the  three  fol- 
lowing arteries  : — 

a.  Art.  corpor.  callos.  [ant.  cerebral],  lies  at  its  commencement 
before  the  chiasma  above  n.  opticus,  then  in  the  scissura 
longitudinal. 


SITUS  VISCERUM.  463 

b.  Art.  fossa  Sylvii  [middle  cerebral],  commences  below  the 
lamina  cribrosa,  then  in  fossa  Sylvii. 

c.  Art.  clwroidea,  external  tocrus  cerebri,  below  tractus  opticus, 
enters  the  cornu  descend,  of  the  lateral  ventricle. 

2.  Circulus  arteriosus  Wittisii,  above  and  close  to  the  sella  tur- 
cica,  surrounds  the  chiasma,  tuber  cinereum   and  corp.  mam- 
millaria. 

3.  Art.  vertebrates,  enters  into  the  cranial  cavity  at  the  posterior 
lateral  part  offoram.  magn.,  lies  at  first  on  the  side  of,  then  ob- 
liquely before  the  medutta  oblongata.     The  two  vessels  unite  and 
pass  as  basilaris  upon  the  clivus. 

a.  Art.  basilaris  gives  off:  art.  auditories,  internee,  cerebeUi  in- 
feriores  and  superiores,  and  divides  at  the  proc.  clinoid. 
post,  into  the  two  artt.  profunda  cerebri  [posterior  cerebral], 
which  pass  around  the  crura  cerebri  to  the  posterior  cerebral 
lobes. 

714.  Thorax  [compare  §  695.] 

After  removing  the  sternum  we  arrive  at  the  pleura  with  the 
lungs  laterally,  in  the  centre  the  cavum  mediastini  antici,  the 
pericardium  with  the  heart,  and  the  cavum  mediastin.  postic.  with 
trachea,  ozsophagus,  vascular  and  nervous  trunks. 

715.  I.   Pleurae.     Each  pleural  sac  is  united  to  the  lateral 
thoracic  parietes  as  pleura  costalis.     The  right  lies  obliquely  from 
above  to  below,  and  from  right  io  left,  so  that  above  it  reaches  as 
far  as  the  right  border  of  manubrium  sterni,  below  to  the  centre 
of  corp.  sterni.     The  left  attaches  itself  to  the  left  border  of  the 
manubrium,  below  to  the  external  extremity  of  the  sixth  and 
seventh-rib  cartilage. 

From  these  points  the  pleura  costalis  turns  backwards  on  either 
side  to  the  lateral  regions  of  the  pericardium  and  the  roots  of  the 
lungs  as  mediastinum  anticum. 

Each  pleura  costalis  goes  backwards  to  the  front  of  the  heads 
of  the  ribs  and  to  the  sides  of  the  vertebral  bodies,  and  hence  turns 
forwards  to  the  lateral  surfaces  of  the  pericardium  and  to  the  roots 
of  the  lungs  as  mediastin.  posticum. 

Below,  the  pleura  is  united  with  the  convex  surfaces  of  the  dia- 
phragm, pleura  phrenica  ;  posteriorly  and  at  the  sides  it  extends 
to  the  last  ribs. 

Ligamentum  pulmonis,  extends  from  the  pleura  phrenica  to 
the  posterior  border  of  the  inferior  lobe  of  the  lungs,  and  here 
passes  over  into  the 

Pleura  pulmonalis,  which  invests  the  entire  surface  of  the  lungs, 


464  TOPOGRAPHICAL  ANATOMY. 

forming  between  the  lobes  ligg.  inter  lobularia,  and  at  the  roots  of 
the  lungs  covering  the  parts  entering  and  passing  out. 

716.  II.  Lungs.     Each  of  the  two  lungs  rests  with  the  con- 
cave  basis  upon  the   convex   surface  of  the   diaphragm.     The 
rounded  apex  reaches  about  one  inch  above  the  first  rib.     Their 
convex  external  surface  is  turned   towards  the  concavity  of  the 
ribs,  and  shows  on  the  right  lung  two  incisurce  interlobulares 
passing  from  behind  forwards,  on  the  left  one  incis.  interlobular •., 
so  that  the  former  is  divided  into  three,  the  latter  into  two  lobes. 

717.  HI.  Pericardium,  extends  from  the  point  of  junction  of 
the  sixth  and  seventh  rib  cartilage  with  the  sternum  of  the  right 
side  :  a  rhomboidai  piece  of  its  anterior  surface   looks  freely  into 
the  cav.  mediast.  anticum.     It  envelopes 

718.  IV.  The  Heart,  the  posterior  inferior  surface  of  which 
rests  upon  the  diaphragm,  the  basis  of  which  lies  to  the  right, 
above  and  behind  as  high  as  the  sixth  dorsal  vertebra,  the  apex 
to  the  left,  in  front  and  below,  behind  the  anterior  extremity  of 
the  cartilage  of  the  sixth  and  seventh  left  ribs.     Sulcus  longi- 
tudinalis,  transversus.     Ventriculi,  atria   and  auricula  cordis 
(see  Heart,  §  527.) 

Besides  the  coronary  veins,  there  open  into  the  heart : 
1.  Vena  cava  superior,  formed  by  the  junction  of  the  two 
anonymce  \ven.  brachio-cephaliccz]  behind  the  first  and  second 
right  costal  cartilages,  passes  before  art.  pulmonal.  dextra,  to  the 
right  and  rather  behind  the  commencement  of  the  Aorta,  into  the 
atrium  dextrum. 

a.  V.  anonyma  dextra  [right  brachio-cephalic]  lies  perpendicu- 
larly before  the  first  (right)  costal  cartilage,  before  and  inter- 
nal to  nerv.  phrenic,  dexter  and  art.  mamm.  intern,  dextra. 

b.  V.  anonym,  sinistra  [left  brachio-ceph.]  horizontal  behind 
the    manubrium,   close    above    arcus    aorta,   before    art. 
anonyma,  carotis  and  subclavia  sinistra. 

3.  V.  cava  inferior,  passes  through  foramen  quadrilaterum  of 
the  diaphragm  from  the  ventral  into  the  thoracic  cavity,  and  im- 
mediately into  the  pericardium,  where  it  turns  forwards  and  to 
the  left,  and  before  the  eighth  and  ninth  dorsal  vertebra  sinks  into 
atrium  dextrum. 

3.  Vena  pulmonales,  pass  forth  with  two  trunks  from  the  root 
of  each  lung,  lie  behind  and  below  the  other  large  blood-vessels  of 
the  heart  and  behind  the  bronchi,  advancing  towards  those  of  the 
opposite  side,  and  opening  into  the  atrium  sinistrum. 

From  the  heart  arise,  besides  the  coronary  arteries, 


SITUS  VISCERUM.  465 

1.  Arteria  pulmonalis,  which  lie  the  most  anterior  of  all  the 
vascular  trunks.     Origin  :  ventriculus  dexter,  behind  auric,  sinis- 
tra,  covering  the  origin  of  the  aorta.     Divides  on  an  elevation 
with  the  third  dorsal  vertebra.     The  left  trunk  passes  obliquely 
backwards  over  vv.  pulmonal.  sinistr.,  before  aorta  descend,  and 
bronchus  sinister  with  two  branches  to  the  left  lung.     The  right 
branch   below  arcus  aortce,  before  bronchus  dexter,  behind  aorta 
ascendens  with  three  branches  to  the  right  lung.     From  the  angle 
of  division  the  lig.  arteriosum  (duct.  art.  Botatti)  passes  to  the 
concavity  of  arcus  aortte,  internal  to  nerv.  vagus  sinister. 

2.  Aorta,  arises  from  the  left  ventricle,  ascends  behind  art. 
pulmonalis  as  aorta  ascendens  from   left  to  right,  lying  there  be- 
tween art.  pulmon.  (to  the  left)  and  v.  cava  sup.  (to  the  right), 
forms  on  an  elevation  with  the  second  intercostal  space  the  arcus 
aorta,  which  passes  from  right  to  left  and  from  before  backwards 
into  the  cav.  mediast.  post. ;  and  downwards  as  far  as  the  fourth 
dorsal  vertebra.     Here  it  descends  as  aorta  descend,  close  to  the 
left  side  of  the  vertebral  column,  first  close,  then  behind  the  oeso- 
phagus, and  passes  through  hiat.  aortic,  in  the  region  of  the 
twelfth  dorsal  vertebra  into  the  abdomen. 

From  its  convexity  arise 

a.  Art.  anonyma  [art.  brachio-cephalic.],  lying  the  farthest 
to  the  right  and  in  front,  behind  manubrium  sterni,  before 
trachea  ;  divides  into  carot.  commun.  and  subclav.  dextrce. 

b.  Carotis  comm.  sinistra,  at  the  commencement  before, 
then  to  the  left  of  trachea  and  cesophagus,  behind  manubrium, 
ven.  brack,  ceph.  sinistra,  and  m.  sterno-hyoideus. 

c.  Subclavia  sinistra,  the  farthest  to  the  left  and  behind, 
before  the  termination  of  m.  longus  colli. 

1 .  Mammaria  interna,  arises  from  the  ant.  inf.  surface 
of  subclavia,  turns,  at  the  commencement,  forwards,  then 
downwards,  passes  inwards  between  two  veins,  before  the 
pleura  on  the  inner  surface  of  (one  to  seven)  costal  car- 
tilages as  far  as  proc.  ensiform.,  where  it  bifurcates  intc 
its  two  terminal  branches,  ram.  musculo-phrenic.  and  epi- 
gastricus. 

719.  V.  Vena  azygos  and  hemiazygos  (v.  conjugate)  pass 
along  on  either  side  between  crus  extern,  and  med.  diaphrag.  into 
the  cavum  mediast.  post.,  passing  close  to  the  bodies  of  the  dorsal 
vertebra  as  high  as  the  eighth,  where  they  unite  in  the  ven.  azy- 
gos. This  passes  upwards  to  the  right  of  the  aorta  and  the  ductus 

30 


466  TOPOGRAPHICAL  ANATOMY. 

tkoracicus  as  high  as  the  third  and  fourth  dorsal  vertebrae,  curves 
around  branch,  dexter  and  art.  pulmon.  forwards  to  the  posterior 
wall  of  ven.  cava  sup.,  in  which  it  terminates. 

720.  VI.  Ductus  tkoracicus  passes  through  hiat.  aortic.,  lying 
between  aorta  thoracic,  and  ven.  azygos  before  the  bodies  of  the 
vertebrae ;  goes  to  the  left,  in  the  region  of  the  fifth  and  sixth  dor- 
sal vertebrae  behind  the  (esophagus  and  the  termination  of  arc. 
aorta,  and  opens  in  the  angle  between  ven.  jugular,  inter  na,  and 
subclavia  sinistra. 

721.  VII.   Trachea,  behind  the  manubr.  sterni,  ven.  anonyma, 
and  carotis  sinistra,  it  divides  before  the  third  dorsal  vertebra,  close 
behind  arcus  aortce,  into  the  two  bronchi.     Bronch.  dexter  [the 
largest]  lies  behind  v.  cava  super.,  passes  away  under  the  curve  of 
v.  azygos  ;  broncli.  sinister  [the  longest  and  most  oblique]  under 
the  arch  of  the  aorta  to  the  lungs.     Both  lie  behind  the  art.  and 
above  the  v.  pulmonales. 

722.  VIII.   (Esophagus  passes  behind  the  trachea  and  rather 
to  the  left  of  it,  into  the  cav.  mediastin.  post.  ;  lying,  at  the  com- 
mencement, more  in  the  central  line,  and  to  the  right  of  the  aorta; 
lastly  to  the  left  and  before  aorta  and  duct,  thoracic.,  and  enters, 
upon  a  plane  with  the  ninth  dorsal  vertebra,  the  abdominal  cavity 
through  for.  ccsophageum. 

723.  IX.  Nerves. 

1.  Nero,  vagus,  passes  down  and  close  to  carotis,  rather  external 
to  it,  before  art.  subclavia  and  behind  ven.  anonyma  obliquely  into 
cav.  mediast.  anticum. 

a.  N.  recurrens  dexter,  passes  off  from  it,  and  around  the 
art.  subclavia  dext.  backwards  to  the  larynx :  sinister  like- 
wise around  the  arcus  aortce.     Both  ascend  behind  the  carotis 
in  the  groove  between  trachea  and  (Esophagus. 

b.  Nn.  pulmonales. 

The  vagus  then  turns  into  the  cav.  mediast.  post.,  passes  ob- 
liquely inwards  behind  the  bronchi  to  the  oesophagus  (the  left  on 
its  anterior,  the  right  upon  its  posterior  surface),  and  are  lost 
through yo/.  ozsophageum  of  the  abdominal  cavity. 

2.  Pars  thoracica  nerv.  sympathici,  lies  on  the  outside  of  cav. 
mediast.  post,  behind  the  pleura  costalis,  close  to  the  vertebral  bo- 
dies, before  the  proc.  transv.  and  heads  of  the  ribs.     Ganglia 
thoracici  (eleven  to  twelve)  between,  upon,  or  before  the  heads  of 
the  ribs. 

a.  Splanchnicus  major,  arises  from  six  to  ten  ganglia 


SITUS  VISCERUM.  467 

thorac.,  entering  the  abdominal  cavity  between  crus  med.  and 
intern,  diaphragm. 

b.  Splanchnicus  minor,  arises  from  nine  to  ten  ganglia, 
perforates  the  crus  medium.  Both  lie  more  anterior  and  in- 
ternal than  the  trunk  of  sympathicus,  before  the  vasa  inter- 
costal.; upon  the  left  side,  close  to  the  aorta;  upon  the  right, 
close  to  ven.  azygos. 

3.  Nervus  phrenicus,  enters  the  cav.  mediastin.  antic.,  on  either 
side  behind  the  outer  portion  of  artic.  ster  no-clavicular  is  before  art. 
subcl.  and  behind  v.  subcl.,  on  the  outer  side  of  art.  mammaria  in- 
terna,  contiguous  to  the  pericardium  ;  the  right  passes  more  ante- 
riorly before  v.  cava  super.,  the  left  curved  around  the  apex  of  the 
heart  to  the  diaphragm. 

T24.  Abdominal  Cavity. 

1.  Within  the  peritoneum  (Infra  peritonaeum). 

1.  Liver,  situated  in  the  hypochondr.  dextr.,  extending  on  the 
left  as  far  as  into  epigastrium.  The  convex  surface  in  the  con- 
cavity of  the  diaphragm,  directed  upwards  and  forwards  ;  the  con- 
cave surface  downwards  and  backwards. 

Lobulus  dexter  covers  the  superior  part  of  the  right  kidney 
(impressio  renalis),  Ihejftexura  coll  dcxlra  (impressio  colica), 
farther  to  the  left  and  before  the  duoden.,  pylorus,  lig.  hepatico- 
renale  and  duodenale  ;  foram.  Winslowii. 

Lobulus  sinister  lies  upon  the  small  omentum  and  the 
cardia  ;  lob.  Spigelii  in  the  curvatura  minor. 

Posterior  superior  border  is  obtuse,  and  unites  with  the  dia- 
phragm. 

Inferior  anterior  border  is  acute,  and  directed  downwards. 
On  the  inferior  surface  :  Fossa  longitudin.  dextra  with  the 
gall  bladder— -fundus  below,  collam  directed  towards  fossa 
transv. ;  passes  into  ductus  cysticus,  which  joins  with  duct, 
hepaticus,  at  an  acute  angle  to  form  the  duct,  chokdoch., 
which  opens  into  the  posterior  wall  of  pars  descend,  duodeni. 
At  the  posterior  part  lies  ven.  cava  inferior. 

Fossa  longitudinal,  sinistra  with  lig.  teres  (ven.  umbilical.) 
before  duct.  ven.  Arantii  behind. 

Fossa  transversa  presents  :  v.  porta  and  art.  hepat.  (ves- 
sels entering),  duct,  hepat.  (passing  out)  surrounded  by  cap- 
sul.  Glissonii,  in  the  lig.  hepatico-duodenak. 

a.  Ven.  portce,  and  to  the  right  before  it  art.  Jiepatica. 

b.  Ductus  hepaticus  before  v.  portce,  between  art.  hepat. 
(to  the  left)  and  duct,  cystic,  (to  the  right). 


468  TOPOGRAPHICAL  ANATOMY. 

c.  Duct,  choledochus  to  the  right,  and  rather  before  the  ven. 
portce,  behind  duodenum. 

2.  Spleen,  situated  in  fiypochondr.  sinistra.     Its  thick  superior 
extremity  on  the  diaphragm,  the  thin  inferior  extremity  above  flex, 
coli  sinistra.     External  surface  towards  the  concavity  of  the  last 
ribs  and  pars  cost,  of  diaphragm.  Internal  concave  surface  bounded 
by  fund,  ventriculi,  presents  hilus. 

3.  Pancreas,  behind  the  stomach,  in  the  reg.  epigastr.,  before 
the  large  vascular  trunks  and  the  vertebral  column.     The  head  in 
the  curve  of  the  duodenum,  the  tail  towards  the  spleen.     The  duct 
(duct.  Wirsungianus)  opens  into  pars,  descend,  duodeni. 

4.  Stomach  in  reg.  epigastrica  and  hypochondr.  sinistra.    Cur- 
vat,  major  below,  minor  above  ;  anterior  wall  behind  the  abdomi- 
nal parietes  ;  posterior  before  pancreas,  aorta  ;  cardia  to  the  left 
and  above,  beneath  for.  cesophageum;  behind  proc.  xiphoideus,  in 
the  scrobiculo  cordis,  and  the  extremity  of  the  left  lobe  of  liver; 
pylorus  to  the  right,  behind  the  lobul.  quadratus.     Fundus  in  the 
reg.  hypochondr.  sinistra,  united  to  the  spleen. 

5.  Duodenum.     First  portion,  pars  horizont.  super,  proceeding 
from  the  pylorus  to  the  right,  curves  below  the  right  lobe  of  the 
liver.     Second  portion,  pars,  descend.,  before  the  right  kidney  to 
the  region  of  the  third  lumbar  vertebra.     Second  curve.     Third 
portion,  p.  horizontal,  infer,  passes  off  to  the  left,  then  between  the 
layers  of  the  mesenterium  into  the  jejunum. 

6.  Jejunum  two-fifths,  and  ileum,  three-fifths,  traverse  regg. 
umbilical.,  hypogast.,  iliaca,  even  into  the  depth  of  the  pelvis  (in 
the  excavat.  recto-uterina  and  vesico-uter.),  passing  in  the  reg. 
iliac,  dext.  into  the  large  intestines. 

7.  Cazcum  ;  with  proc.  vermiform,  behind  and  external  in  reg. 
iliac,  dextra,  upon  m.  iliacus  dexter. 

8.  Colon,  ascendens,  transvers.,  descendens  with  sigmoid flexure 
passes  by  the  side  of  the  last  lumbar  vertebra  into  the  rectum. 

9.  PerUonceum,  extends  from  the  umbilicus  upwards  on  the  in- 
ternal surface  of  the  abdominal  parietes  to  the  diaphragm,  forming 
in   this  way,  as    it  surrounds   the  lig.  teres,  the  lig.  suspensor. 
hepatis. 

From  the  concavity  of  the  diaphragm  it  descends  to  the  obtuse 
border  of  the  liver  as  lig.  coronar.  hepatis,  which  at  the  sides  passes 
over  into  the  anterior  layer  of  ligg.  triangularia ;  covering  the 
convexity  of  the  liver  it  turns  over  the  acute  border  to  the  inferior 
surface  which  it  also  covers  as  far  as  lobulus  Spigelii,  and  com- 
pletes laterally  the  ligg.  triangularia.  From  the  fossa  transv.  it 
goes  to  ihejlexur.  coli.  dextr.  and  right  kidney  (lig.  hepatico-coli- 
cum  and  -renale)  farther,  to  the  curvat.  minor,  (lig.  hepat.  gastric. 


SITUS  VISCERUM.  469 

s.  omentum  minus),  and  to  the  duodenum  (as  lig.  hepatico-ditode- 
nak,  which  is  continued  to  the  right  kidney  as  lig.  duodeno-renale). 
On  the  left  side  it  descends  from  the  diaphragm  to  the  anterior  wall 
of  the  stomach  and  the  spleen  (lig.  phrenico- gastric,  and  one  layer 
of  lig.  phrenico-lienak),  covers  the  anterior  surface  of  the  stomach, 
descends  as  one  layer  of  the  great  omentum  [turns  upon  itself], 
and  ascends  as  the  fourth  layer,  covering  the  colon  transvers.  as 
mesocolon  transvers.,  passes  to  the  [inferior]  border  of  pancreas, 
and  attaches  itself  to  the  posterior  abdominal  parietes. 

Foramen  Winslowii  is  a  space  between  ven.  cava  and  v.  porta- 
rum  below  the  tubercul.  caudatum  of  the  liver.  Through  this  the 
saccus  epiploicits  is  tucked  in.  The  anterior  layer  covers 

lobulus  Spigelii,  forms  the  posterior  layer  of  lig.  gastrico-ke- 
pniic.  (small  omentum),  covers  the  posterior  surface  of  the 
stomach,  descends  as  second  layer  of  great  omentum,  and  as 
third  layer  again  ascends,  covering  [the  transv.  colon]  the 
anterior  surface  of  the  pancreas,  and  turning  back  at  the  tobul. 
Spigelii. 

Mesenterium.  The  root  of  the  mesentery  extends  from  the 
second  lumbar  vertebra  to  the  symphys.-sacro-iliac.  dextr.  Be- 
tween its  two  layers  are  found  the  convolutions  of  the  small  intes- 
tines. From  the  symph.  sacro-iliac.,  the  peritoneum  is  continued 
upon  the  ccecum,proc.  vermiform.,  colon,  and  rectum. 

In  the  male  it  passes  from  the  anterior  surface  of  the  rectum  to 
the  posterior  of  the  urinary  bladder,  since  it  forms  the  ezcavat. 
recto-vesicalis,  and  on  both  sides  the  plicce  semilunares  Douglasii, 
covers  the  lateral  two-thirds  of  the  posterior  surface  of  the  bladder, 
invests  laterally  the  lig.  vesicle  lateralia,  and  above  the  lig.  vesicce 
suspensor.,  and  then  again  ascends  to  the  posterior  surface  of  the 
anterior  abdominal  parietes. 

In  the  female  it  forms  the  ezcavat.io-recto-uterin.,  plic.  Dougl., 
lig.  uteri  lota,  plica  and  excav.  vesico-uterince,  passes  upon  the 
bladder,  and  so  on. 

Uterus  lies  in  great  part  covered  by  peritoneum,  above  the  va- 
gina, between  bladder  and  rectum,  with  thefundus  in  the  entrance 
to  the  pelvis. 

Tuba  FaUopice  lies  at  the  entrance  to  the  pelvis,  before  and 
above  the  ovary,  at  the  side  of  the  uterus  ;  its  external  extremity 
projects  freely  into  the  abdominal  cavity. 

Ovarium,  between  the  layers  of  the  broad  ligament,  over  the 
round  ligament,  on  the  side  offundus  uteri,  and  united  with  it  by 
lig.  ovarii. 

Lig.  uteri  rotundum,  below  the  tuba  and  the  ovarium,  on  the 
lateral  borders  of  the  uterus. 


470  TOPOGRAPHICAL  ANATOMY. 

725.  II.  Outside  the  peritoneum, 

in  the  abdominal  and  pelvic  cavities  are  situated :  the  capsules, 
supra  renales,  the  urinary  organs,  internal  organs  of  generation, 
the  rectum,  the  superior  portion  of  the  duodenum,  the  great  ves- 
sels and  nerves. 

1.  Caps.  sup.  renales,  situated  in  the  reg.  hypochondriaca  on 
the  posterior  abdominal  walls,  upon  the  upper  border  of  the  kid- 
ney, below  the  diaphragm,  the  right  behind  the  liver,  the  left  be- 
hindfundus  ventriculi. 

2    Urinary  organs,  viz.  kidneys,  ureters,  bladder. 

a.  Kidneys.  They  are  placed  in  the  reg.  lumbalis,  before  m. 
quadratus  lumborum  and  the  eleventh  and  twelfth  ribs,  close  to 
the  first  and  third  lumbar  vertebrae,  behind  the  peritoneum  ;  the 
right  kidney  behind  lobul.  dexter,  duodenum,  and  colon  ascendens  ; 
the  left  behind  the  inferior  extremity  of  the  spleen,  cauda  pancreat. 
and  colon  descendens. 

The  internal  border  with  the  hilus,  rests  upon  the  pars  lumbal. 
of  diaphragm  and  m.  psoas.  In  the  hilus  lie,  from  before  back- 
wards, vena,  arteria,  pelvis  renalis. 

b.  "Ureter^  descends  obliquely  inwards  from  the  pelvis  of  the 
kidney,  with  a  sigmoidal  curve ;  before,  m.  psoas  and  vasa  iliaca  ; 
behind,  the  vasa  spermatica,  which  descend   obliquely  outwards, 
and  cross  it ;  it  passes  between  rectum  and  psoas  into  the  pelvic 
cavity,  and  to  the  posterior  wall  and  lateral  parts  of  the  fundus 
vesicce.     Here   it  lies  in  the  male,  at  first  on  the  side,  then  be- 
tween the  rectum  and  urinary  bladder,  behind  vas  deferens  ;  in 
the  female,  close  to  collum  uteri,  below  lig.  uteri  rotund.,  then 
between  bladder  and  vagina. 

c.  Urinary  bladder  ;  it  lies  in  reg.  pubis,  between  the  pubic 
bones  and  the  rectum  or  uterus  : 

1.  Corpus  vesicce,  behind  the  symphysis  pubis,  before  the 
rectum  or  uterus,  touching  laterally  the  side  walls  of  the 
pelvis. 

2.  Vertex,  projects  upwards  as  far  as  the  superior  border 
of  symphysis  pubis,  or,  even  above  this,  covered  behind  by 
peritoneum. 

3.  Fundus,  situated  anteriorly  upon  the  perinaum,  above  the 
vesicula  seminal,  andvasa  deferent., behind  upon  the  inferior 
portion  of  rectum  (in  the  male) ;  upon  the  anterior  wall  of 
vagina  (in  the  female). 

4.  Collum  (in  the  male  surrounded  by  the  prostate),  lies  over 
the  anterior  part  of  perinceum  (the  vagina  in  female),  close 
behind  the  lower  border  of  symphysis. 


SITUS  VISCERUM.  471 

3.  Internal  organs  of  generation. 

a.  Prostata  surrounds  the  coUum  vesicce,  and  the  commence- 
ment of  the  urethra,  situated  close  before  the  vesicul.  seminal. 
and  vasa  deferent.,  above  the  perinceum  and  the  lower  extremity 
of  rectum ;  its  anterior  pointed  extremity  behind  and  below  the 
lig.  arcuatum. 

b.  Vesiculce  seminales  are  placed  close  together,  behind  and 
above  the  prostata,  between  rectum  and  fundus  vesicce ,  before  and 
external  to  the  ureters  and  vasa  deferentia. 

c.  Vas  deferens,  passes  on  either  side  through  the  internal  in- 
guinal ring  into  the  abdominal  cavity,  bends  round  art.  epigastrica 
and  over  vasa  cruralia  backwards,  inwards,  and  downwards,  lying 
at  first  at  the  side,  then  on  the  fundus  of  the  urinary  bladder,  be- 
fore the  ureter,  and   internal  to  the  vesic.  seminal,  of  its  own 
side. 

d.  Vagina,  between  rectum  and  bladder,  below  the  fundus 
vesicce  and  urethra,  in  the  axis  of  the  lesser  pelvis. 

4.  Rectum :  it  lies  on  the  posterior  wall  of  the  pelvis  from  the 
promontorium  down  to  the  end  of  the  coccyx  ;  in  women,  behind 
uterus  and  vagina  ;  in  men,  behind  and  below  the  prostate,  blad- 
der, vesicuke  seminales,  and  vasa  deferentia.     Its  most  superior 
portion  is  covered  in  front,  and  laterally  by  the  peritoneum. 

5.  Vessels : 

a.  Aorta  abdominalis  descends  through  hiatus  aorticus  into  the 
abdomen,  lies  close  to  the  anterior  surface  of  the  lumbar  vertebrae 
(as  far  as  the  cartilage  between  the  fourth  and  fifth),  to  the  left  of 
ven.  cava  infer.,  behind  the  cardia,  caput  pancreat.,  third  portion 
of  duodenum,  radix  mesenterii.     Its  branches  : 

1 .  Phrenicce  inferr.  andcceliaca,  arise  close  under  hiatus  aorticus. 

2.  Lumbares  I.,  mesenterica  super.,  arise  before  the  twelfth  dor- 
sal vertebra. 

3.  Supra  renales,  renales,  spermaticce  intern.     Lumbares  II., 
before  the  second  lumbar. 

4.  Lumbares  III.,  arise  before  the  third  lumbar. 

5.  Mesenterica  inferior,  between  third  and  fourth  lumbar. 

6.  Lumbares  IV.,  before  the  fourth  lumbar. 

7.  Sacra  media  and  iliacce,  between  fourth  and  fifth  lumbar. 

b.  Artt.  iliacce,  communes  descend  obliquely  from  the  place  of 
division  of  the  aorta  outwards  and  backwards  behind  the  ureters^ 
on  the  inner  side  of  m.  psoas,  as   far  as  symphys.  sacro-iliaca. 
The  left  lies  immediately  before  the  vena  iliaca  sinistra  on  the 
outside,  the  right  goes  first  over  v.  iliaca  sinist.,  and  then  passes 
to  the  inner  side  of  v.  iliaca  dextra.     Their  branches : 


472  TOPOGRAPHICAL  ANATOMY. 

1.  Hypogastrica  [iliac  intern.],  lies  close  before  symphys.  sa- 
cro-iliaca,  at  the  side  of  the  posterior  wall  of  the  small  pelvis. 

2.  Iliaca  externa  lies  in  the  great  pelvis,  between  vena  iliaca 
(internally)  and  nerv.  cruralis  (externally,)  before  fasc.  ili- 
aca and  psoas,  passing  under  the  crural  arch. 

c.  Vena  cava  inferior,  arises  rather  below  the  division  of  the 
aorta,  ascends  on  its  right  side,  inclines  rather  to  the  right  and  for- 
wards, and  passes  behind  the  pancreas,  before  the  right  crus  of  the 
diaphragm  into  the  fossa  pro  ven.  cava  of  the  liver,  between  lobulus 
dexter  and  Spigelii  ;  hence  through  for  am.  quadrilaterum  into  the 
thorax.     Its  branches : 

Vv.  iliaca  communes,  pass  on  the  right  side  of  the  correspond- 
ing arteries;  the  left  longer,  behind  the  origin  of  art.  iliaca  dextra, 
before  art.  sacra  media. 

1.  V.  hypogastrica,  lies  behind  its  artery. 

2.  V.  iliaca  externa,  on  the  inner  side  of  the  artery. 

d.  Vena  azygos  arises  before  the  second  and  third  lumbar  verte- 
bra (on  the  right)  by  the  junction  of  branches  of  v.  iliaca,  renalis, 
and  cava  infer,  with  the  lumbalis  ascend.,  passes  between  the  cen- 
tre and  external  right  crus  diaphragm,  (or  through  hiatus  aortic.) 
into  the  thorax. 

e.  Vena  hemiazygos,  arises  on  the  left,  and  takes  a  course  like 
ven.  azygos. 

d.  Ductus  thoracicus,  formed  by  two  trunci  lumbales  and  one 
lymphatic,  intestinal.,  arises  before  the  first  and  second  lumbar 
vertebra  to  the  right  of  and  behind  aorta  abdominal.,  close  to  art. 
mesenter.  super,  (or  renal,  dextra),  passes  through  hiatus  aorticus 
into  the  thorax. 

6.  Nerves  : 

a.  Plexus  lumbalis  /  lies  in  and  behind  m.  psoas,  before  m.  qua- 
drat, lumborum.     Its  continuation :    nerv.  cruralis   lies   in    the 
groove  between  m.  psoas  and  iliacus,  under  fasc.  iliaca,  at  first 
behind  ;  then  on  the  outer  side  of  art.  iliaca. 

b.  Plexus  sacralis  s.  ischiadicus  lies  behind  art.  hypogastrica, 
ischiadica,  and  pudenda,  before  n.  pyriformis  at  the  inferior  ex- 
tremity of  incisura  ischiadica  major. 

c.  N.  sympathicus.     The  lumbar  portion  lies  on  the  sides  of  the 
bodies  of  the  lumbar  vertebra,  the  gangl.  lumbalia  dextra  behind 
aorta,  the  gangl.  lumb.  sinist.  behind  v.  cava.     The  sacral  por- 
tion— close  before  the  os  sacrum;  the  (four)  gangl.  sacralia  at 
the  inner  edge  of  foramina  sacrall.  anteriora.    Gangl.  coccygeum, 
the  termination  of  n.  sympathicus  on  the  anterior  surface  of  the 
sacrum. 


INDEX. 


'„.*   The  numbers  refer  to  the  antique  figures. 


A. 


Abdomen,  696. 

Acetabulum,  92. 

Acidum  lacticum,  12;  uricum,  11. 

Acini  hepatis,  445 ;  Malpighi,  470. 

Acromion,  94. 

Aditus :    ad   aquaeduct.   Sylvii,  620 ; 

ad  cochleam,  52;  ad  infundibulum, 

620 ;  ad  vestibulum,  52. 
Adminiculum  lineae  albae,  261. 
Alae    Ingrassiae    (alae    minores),    48 ; 

magnae,  48;  nasi,  517;  pterygoid., 

48 ;     sacrales,    79 ;     vespertilionis, 

486. 

Albumen,  6. 
Alveoli,  66. 
Amphiarthrosis,  45. 
Ampulla    chyli,    438  ;    membranac., 

515;  ossea,  512, 
Anastomosis  Jacobsonii,  511. 
Angiologia,  520. 
Angulus  costs,  85  ;  facial.  Camperi, 

73 ;  maxillae,  66  ;  oculi,  492 ;  oris, 

428 ;  pubis,  92. 
Annulus  abdominalis,  258 ;   cruralis, 

364;    digitorum,   336,  377;    ingui- 

nalis,  258,  260 ;  tympani,  52 ;  um- 
bilical, 261. 
Ansa  capitis,  52. 
Anthelix,  506. 
Antitragus,  506. 
Antrum  Highmori,  59. 
Anus,  444. 
Aorta  ascend.,  539  ;    descend,  570 ; 

abdom.,  571 ;  thorac.,  570. 
Aperturae  pelvis,  93 :  pyriform,  69. 
Aponeuroses,  146 ;    bicipit.  319 ;   is- 

chio-pubica,   282;     -rectalis,   282; 

palmar.,  333;  plantar,  596. 
Apophysis,  41. 
Apparatus  ligamentos.,  111. 
Appendices  epiploic.  s.  adiposae,  441 ; 
iform., 


app.  vermiform.,  442. 


Aquaeductus  cochl.,  514 ;  Sylvii,  620 ; 
vestibuli,  52,  514. 

Aquula  Cotunni,  515  ;  vitrea,  515. 

Arachnoidea,  624,  628  ;  oculi,  499. 

Arbor  vitae  cerebelli,  621 ;  uteri,  486. 

Arcus  aortae,  540 ;  cruralis,  256  ;  dor- 
sal, carpi,  569  ;  pedis,  587 ;  glosso- 
palatin.,  428  ;  pharyngo-palatin., 
428  ;  plantaris,  587;  pubis,  92  ;  su- 
perciliaris,  50;  t  arse  us  infer,  et  su- 
per., 551 ;  volaris  carpi,  569 ;  tarsis, 
587. 

Area  Martegiani,  504. 

Areola  mammae,  489. 

Arteriae,  524 ;  A.  acetabuli,  577,  582 ; 
acromialis,  561 ;  adiposae,  573 ;  al- 
veolaris,  547;  anonyma,  540;  an- 
gularis,  551 ;  aorta,  537 ;  dppendi- 
calis,  572 ;  articulares  genu,  583 ; 
aspera,  466 ;  auditiva,  555  ;  auricu- 
lares,  545,  546  ;  axillaris,  560. 

B.  Basilaris,  555;  brachialis,  564; 
breves,  572 ;  bronchiales,  570  ; 
buccinatoria,  548 ;  bulbosa,  579. 

C.  capsularis,  551 ;  cardiacae,  539; 
carotis,   540,   550;    cavernosa, 
579 ;  centralis  retinae,  551 ;  ce- 
rebelli,  555;     cerebralis,   552, 
555 ;    cervicalis,   557 ;    choroi- 
dea,  552 ;  ciliares,  551 ;  circum- 
flexae    femoris,    582;    humeri, 
563 ;     ilium,    581 ;    clitoridea, 
579  ;  cochleae,  see  auditiva :  cce- 
calis,  572 ;  caeliaca,  572 ;  colica, 
572  bis ;  collaterals,  566  bis ; 
communicans,  552;    coronariae 
cordis,    539 ;    labiorum,    544 ; 
ventriculi,   572;    corporis  cal- 
losi,  552;   cruralis,  580:  cubi- 
talis,  568 ;  cystica,  572. 

D.  deferentialis,   577 ;    dentalis, 
548,  549;   digitales,  569,  587; 
dorsalis  linguae,  543  :  nasi,  551 ; 
penis  (clitoridis),  579;  pollicis, 


31 


474 


INDEX. 


567;   scapulae,  557;    duodena- 
les,  572. 

E.  emulgentes,  see  renales:  epi- 
gastrica  externa,  581  ;  inferior 
sen  interna,  581 ;  superficialis, 
582 ;     superior,    559 ;    ethmoi- 
dales,  551. 

F.  faciales,  543 ;  f.  profunda,  546 ; 
f.  transversa,   546 ;    femoralis, 
582;  fibularis,  586 ;  fossae  Syl- 
vii,  552;  frontalis,  551. 

G.  gastro-duodenalis.  -epiploicae, 
572  bis  ;  glutaei,  578. 

H.  haemprrhoidal.  extern,  s.  infer. 
579 ;  interna,  572 ;  media,  577  ; 
helicinae,  579 ;  hepatica,  572  ; 
hypogastrica,  576. 
I.  jejunales  et  ileas  s.  intestinales, 
572 ;  ilep-colica,  572 ;  ileo-lum- 
balis  s.  iliaca  anterior,  578 ;  ili- 
aca  commun.,  575;  externa, 
581 ;  interna,  576  ;  posterior, 
578  ;  infra-costalis,  570 ;  infra- 
orbitalis,  548;  infra  see  sub- 
scapularis  ;  inguinales,  582  ; 
innominata  s.  anonyma :  inter- 
costales,  558,  570 ;  interosseae, 
567,  568,  585,  587  bis;  ischia- 
dica,  579. 

L.  labiales,  544,  579,  582 ;  lacry- 
malis,  551 ;  laryngeae,  543,  556  ; 
lienalis,  572 ;  lingualis,  543 ; 
lumbales,  573. 

M.  mammaria  externa,  558 ;  in- 
terna, 558 ;  rnalleolares,  584, 
586 ;  masseterica,  547 ;  mastoi- 
dea,  545 ;  maxillaris  externa, 
543 ;  interna,  546  ;  mediastinae, 
570;  meningeae  antic.,  551; 
magna  s.  media,  547;  parva, 
547  ;  posteriores,  545  bis,  554  ; 
mentalis,  547 ;  mesaraica  infer., 
572;  super.,  572;  metatarsea, 
585, 587;  muscularesoculi,  551 ; 
mylo-hyoidea,  547. 
N.  nasalis,  544,  549,  551  bis ;  nu- 
tritia  femor.,  582  ;  tibiae,  586  ; 
ulnae,  568. 
O.  obturatoria,  577;  occipitalis, 
545;  oesophageae,  570;  om 
phalo-mesaraica,  572;  ophthal- 
mica,  551 ;  ovarica,  577. 
P.  palatinae,  544 ;  palpebrales 
551 ;  pancreaticae,  572  bis ;  pe- 
diaea,  585;  penis,  579;  perfo- 
rantes,  582 ;  pericardiacae  s 
mediastinae :  phrenicae,  573;  pe- 
rinaea,  579;  peronaea,  586 ;  pha- 
ryngea  ascend.,  545  ;  suprema 


a.  vidiana:  pinnales,  544  ;  plan- 
tares,  586;  poplitaea,  583  ;  prin- 
ceps  pollicis,  567 ;  profunda 
brachii,  566  ;  femoris,  582;  pe- 
rinaei,  579  bis ;  penis,  579 ;  pte- 
rygoideae,  547;  pterygo-palat., 
-  549 ;  pubica  s.  pudenda,  577, 
579 ;  externa,  582 ;  pulmonalis, 
535 ;  pylorica,  572. 
R.  radialis,  567 ;  ranina,  543  ;  re- 
currens,  567,  568,  584  ;  renalis, 
573. 

S.  sacci  iacrymal.,  551 ;  sacra  la- 
teral., 578;  media,  574;  scapu- 
laris,  557 ;  scrotales,  579,  582 ; 
septi  mobil.,  544 ;  narium,  549 ; 
spermatica,  573,  581 ;  spheno- 
palatina,  549  ;  spinales,  554  ; 
spinosa,  547  ;  splenica  s.  liena- 
lis, stylo-mastoidea,  545  ;  sub- 
clavia,  553  ;  sublingualis,  543  ; 
submentalis,  544 ;  subscapula- 
ris,  563  ;  supraorbitales,  551 ; 
suprarenal.,  573;  suprascapu- 
lar,  557 ;  surales,  583. 
T.  tarseae,  551,  585,  587  ;  tempo- 
rales,  546  bis  ;  547  ;  thoraciae, 
561,  562;  thymicae,  558;  thy- 
reoideffl,  543,  556 ;  tibialis,  584, 
586  ;  tracheales,  556 ;  tonsilla- 
1  ris,544;  transversa cervic., 557; 
faciei,  546  ;  perinaei,  579 ;  sca- 
pulae, 557;  tubaria,  577;  tym- 
panicae,  547,  549. 
U.  ulnaris,  568 ;  umbilicalis,  577; 

uterina,  577. 

V.  vaginalis,  577  ;  venosa  s.  pul- 
monalis :  vertebralis,  554 ;  ve- 
sicales,  577  ;  vidiana,  549. 
Arthrodia,  45. 
Arthrologia,  110. 

Articulat.  acromio-clavicular.  119;  ca- 
pitis,  112;  carpi,  123  ;  carpo-carpal., 
125;  carpo-metacarpea,  126;  costo- 
vertebral.,  115  ;  coxae,  129;  cubito- 
humeralis,  cubiti,  121 ;  digitorum 
manus,  128;  pedis,  132;  genu,  130; 
humeri,  120;  maxillaris,  114;  me- 
tatarsi, 136;  radio-cubital.,  122; 
sterno- clavicular.,  118;  -costal., 
116;  tali  s.  pedis,  132;  tarsi,  133; 
tibio  -  fibular,  131 ;  tibio-tarsalis, 
132;  vertebrarum,  111. 
Astragalus,  106. 
Atlas,  77. 

Atria  cordis,  527,  528. 
Auricula,  505  ;  cordis,  527. 
Auriculus,  506. 
Auris,  505. 


INDEX. 


475 


B. 

Balanus,  482. 

Barba  s.  crines. 

Bilin,  10. 

Brachia,  94. 

Bronchi,  466. 

Bronchia,  467. 

Buccae,  428. 

Bulbus  aortae,  537;  cavernos.,  482; 
cinereus,  630 ;  fornicis,  618 ;  oculi, 
496;  olfactor.,  630;  pili,  26;  ven. 
jugular.,  592;  urethra,  473. 

Bursae  mucosae  s.  synoviales,  148. 


C. 


C acumen,  622. 

Calamus  scriptorius,  618. 

Calcaneus,  106. 

Calx,  106. 

Calyces  renales,  471. 

Camera  oculi,  502. 

Canales:  alveolaris,  66;  caroticus, 
52  ;  central,  modioli,  514 ;  cruralis, 
365  ;  Fallopiae,  52 ;  Fontanae,  497 ; 
incisivus,  59 ;  infra-orbitalis,  59  ; 
inguinalis,  259 ;  intestinalis,  437 ; 
lacrymalis,  64 ;  palatin.,  60;  petiti, 
504;  pterygo-palatin.,  48;  sacral., 
79 ;  Schlemmii,  497 ;  semicircu- 
lares,  513 ;  membranac.,  515 ;  spi- 
nalis,  80;  spiralis  cochl.,  514;  sta- 
pedii,  509;  tympanicus,  52;  vagi- 
nalis,477;  vertebralis,80;  vidianus, 
48;  zygomaticus,  61. 

Canaliculus  mastoideus,  52. 

Canaliculi  lacrymales,  494. 

Canthi  oculi,  492. 

Capilli  s.  crines. 

Capsulap :  adipose  rents,  470 ;  atra- 
biliariae  s.  renes  succenturiati ;  Glis- 
sonii,  445  ;  lentis,  503  ;  bulbioculi, 
496  ;  synoviales,  110,  148. 

Caput,  46,  682;  epididymid.,  477; 
gallinagin.,  473. 

Cardia,  436. 

Caro  linguae,  429 ;  quadrata  Sylvii, 
392. 

Carotis  cerebralis,  550  ;  facialis,  542. 

Carpus,  99. 

Cartilagines,  32,  85,  111 ;  annularis 
s.  cricoidea,  462 ;  arytaenoid.,  462; 
auris,  506 ;  dentis,  433 ;  falcatae  s. 
semilunares  genu,  130 ;  fibrosae,  32 ; 
formativa  s.  ossium,  43;  nasi,  518  ; 
pyramidal,  s.  arytaenoid.,  462 ;  San- 
torin.,  462;  scutiform.  s.  thyreoidea, 
462;  triangular,  intermed.,  122  bis ; 
Wrisbergian.,  462. 


Carunculae:  lacrymalis,  493;  myrti- 
formes,  487 ;  sublingualis,  430. 

Cauda  equina,  627. 

Cavitas  abdominis,  724:  cranii,  57, 
708 ;  glenoidalis,  52,  94 ;  nasi,  69  ; 
oris,  70,  687 ;  pelvis,  93 ;  thoracis, 
87,  695  ;  tympani,  509. 

Cavum  cranii,  57 ;  dentis,  431 ;  medi- 
astini,  468 ;  uteri,  486. 

Cellulae,  13 ;  ae'reae  s.  pulmonales, 
467 ;  ethmoidales,  49 ;  lacrymales, 
49*;  mastoideae,  52 ;  medullares, 
42 ;  nucleate,  13 ;  palatinae,  49. 

Centrum  semicirculare,  620;  semi- 
ovale  Vieussens,  620;  tendineum, 
266. 

Cerebellum,  616. 

Cerebrum,  615 ;  abdominale,  680. 

Cerumen,  507. 

Cervix  uteri,  486. 

Chiasma  nerv.  optic.,  618. 

Choanae,  69. 

Chorda?:  longitudin.  Lancisii,  619; 
tendineae,  528;  transversal,  cubiti, 
122 ;  tympani,  639  ;  vocales  s.  ligg. 
vocalia,  463. 

Chorion,  484. 

Chylus,  34. 

Cilia,  492 ;  vibratoria,  20. 

Circulatio  sanguinis,  531. 

Circulus  arter.  Willis.,  555  :  arter.  et 
venos.  irid.,  500. 

Circumferentia  articular.,  98. 

Cisterna  chyli.  601. 

Clavicula,  95. 

Clitoris,  488. 

Clivus,  48. 

Cochlea,  514. 

Coecum,  442. 

Coles  s.  penis,  482. 

Colla,  8. 

Colliculi :  u.  optici,  501 ;  seminalis, 
473. 

Collum  vesicae  urinariae,  472. 

Colon,  443. 

Columella,  514. 

Columnae  fornicis,  619 ;  rugarum 
recti,  444 ;  vaginae,  487 ;  vertebra- 
lis,  74. 

Commissurae :  alba,  627 ;  anterior, 
620;  cinerea,  627;  labior.  pudend., 
488;  cerehri  magna,  619;  mollis, 
620 ;  posterior,  620. 

Conarium,  619. 

Conchae  :  auris,  506  ;  inferiores  nasi, 
64  ;  mediae  Morgagni,  49. 

Condyli  femoris,  102 ;  humeri,  96 ; 
maxill.  inf.,  66;  occipital.,  47;  sca- 
pulae, 94 ;  tibiae,  103  ;  ulnae,  97. 


476 


INDEX. 


torcul.    Hero- 


Confluens    sinuum  s. 

phili,  625. 

Conjunctiva,  492,  497,  498. 
Conus    medullaris,    627;    vasculos. 

Halleri,  477. 
Cor,  527. 
Corium,  39. 

Cornea,  498 ;  opaca,  497. 
Cornicula  Santorini,  462. 
Cornua:  ammonis,  620;  Bertini,  48; 

coccygea,    80 ;    hyoid,    majora    et 

min.,  67;    limacum,  494;  sacralia, 

79. 

Corona  ciliaris,  504 ;  glandis,  482. 
Corpora :    bigemina,  619 ;   callosum, 

619 ;    candicantia    s.    albicantia    s. 

mammillaria,  618 ;  cavernos.  penis, 

482;    urethrae,  473;    ciliare,  499; 

geniculata,    618,    620 ;    Highmori, 

477 ;  luteum,  483  ;  mamillaria,  614, 

618;    olivaria,    618;     pyramidalia, 

618 ;    quadrigemina,  619  ;    restifor- 

mia,  618,  623 ;  rhomboideum,  621 ; 

striatum,  620 ;  trigonum,   471 ;  vi- 

treum,  504. 
Corpuscula  triticea,  67 ;  lienis,  451 ; 

Pacinian.,.612. 
Costa,  85. 
Coxa,  89. 
Cranium,  53. 
Crines,  26. 
Cristae :  frontales,  50 ;  galli,  49 ;  ilei, 

90;  lacrymalis,  63;  nasalis,  59,  62; 

occipitales,   47;    sphenoidalis,   48; 

turbinalis,  60 ;  pyramidalis,  512. 
Cruor,  36. 
Crura  cerebelli,   618,   621;   cerebri, 

618,  620;  diaphrag.,  266;  fornicis, 

619  ;    gland,  pineal.,  619 ;   medull. 

oblongat.,  618,  621 ;  uteri,  486. 
Crus,  103. 
Cryptae  Lieberkiihnian.,  441 

ceae  s.  follicul.  sebac.,  39. 
Cubitus  s.  ulna. 
Culmen,  622. 
Cunnus,  488. 
Cupula,  514. 
Cutis,  39. 
Cystis  fellea,  447. 
Cytoblastema,  13. 
Cytoblastus,  13. 


D. 


Dartos,  476. 
Declive,  622. 
Denies,  431. 
Dentitio,  433. 


Descensus  testiculi,  477. 

Detrusor  urinae,  472. 

Diaphragma,  266. 

Diaphysis,  41. 

Diarthrosis,  45. 

Didymi,  477. 

Digiti  manus,  101 ;  pedis,  108. 

Diploe,  42. 

Discus  proligerus,  484. 

Diverticulum  Vateri,  439. 

Dorsum  s.  columna  vertebral.,  74. 

Ductus  arter.  Botall.,  535  ;  Bartholin., 

430;     biliferi,    445;     choledochus, 

449  ;  cysticus,  448  ;  deferens,  478 ; 

ejaculatorius,  479  ;  hepaticus,  446  ; 

naso-lacrym.,  494;    lactiferi,   489; 

pancreaticus  s.  Wirsungianus,  450 ; 

Riviniani,  430  ;  Stenonianus,  430 ; 

thoracicus,  601 ;  venos.  Arantii,  445; 

Whartonianus,  430. 
Dura  mater  encephali,   624 ;  medull. 

spinal.,  628. 


E. 


Eminentiae :  arcuata,  52 ;  capitata, 
96  ;  ileo-pectinea,  92 ;  carpi,  99 ; 
intermedia,  103  ;  pyramidalis  s.  pa- 
pillaris,  509  ;  eminentiae  teretes, 
623. 

Emissaria  Santorini,  625. 

Enarthrosis,  45. 

Encephalon,  614. 

Endocardium,  528. 

Ephippium,  48. 

Epidermis,  39. 

Epididymis,  477. 

Epigastrium,  696. 

Epiglottis,  462. 

Epiphysis  s.  ossa. 

Epiploon,  457. 

Epistropheus,  77. 

Epithelium,  19. 

Excayatio  ischio-rectalis  s.  fossa  peri- 
naei:  recto-uterina,  453;  recto-ve- 
sical,  453 ;  vesico-uterina,  453. 

Extremitates  abdominales  s.  inferi- 
ores,  102;  thoracicae  s.  superiores, 
94. 

F. 

Facies  s.  ossa  faciei:  auricular.,  79, 

90 ;  lunata,  92. 

Falx  cerebelli,  624  ;  cerebri,  624. 
Fasciae,    146;  abdominales,   267;  ani 

s.  perineal.,  283;  antibrachii,  319 ; 

brachii,  298 ;  bucco-pharyngea,  181; 


INDEX. 


477 


bulbi  s.  capsula  bulbi,  496 ;  cervi- 
calis,  210 ;  clavicularis,  219 ;  com- 
munis  superf.,  146 ;  cruralis,  379 ; 
cubiti,  319;  dentata,  620;  femoris 
s.  lata,  361  ;  iliaca  s.  lumbo-iliaca, 
349 ;  ilio-pubica,  349 ;  lata,  361 ; 
lumbo-dorsalis,  252 ;  dorsalis  ma- 
ims, 334 ;  nuchae,  252 ;  palmaris  s. 
aponeuros. :  parotideo-masseteric., 
180 ;  pedis,  396 ;  pelvis,  284  ;  peri- 
naei,  281,  283;  plantaris,  396  ;  prae- 
vertebral.,  211;  subscapularis,  291 ; 
supra-spinata,  291 ;  superficial^ 
abdom.,  267  ;  pector.,  219  ;  tempo- 
ralis,  179;  transversal,  abdom.,  268. 

Fasciculus  unciformis,  623. 

Fauces,  434. 

Fel,  10. 

Femur,  102. 

Fenestra  cochleae  B.  rotunda,  509 ; 
ovalis  s.  vestib.,  509. 

Fibro-cartilagines  s.  cartill.  fibross. 

Fibula,  104. 

Filamenta:  terminal,  medull.  spin., 
628. 

Fimbria,  620;  tubas  Fallop.,  485; 
linguae,  429. 

Fissura:  Glaseri,  52;  orbital,  infer., 
48;  super.,  48,  57;  sphenoidal.  s. 
spheno-maxillar.,  48. 

Fistula  sacra  s.  medulla  spinal. 

Flocculus,  621. 

Focile  majus  s.  ulna,  minus  s.  radius. 

Folium  cacuminis,  622. 

Folliculi  dentium  s.  dentes,  Graafiani, 
484  ;  mucosi,  40  ;  pilorum,  26  ;  se- 
bacei,  39. 

Fonticuli,  55. 

Foramina:  alveolar,  infer.,  66;  pos- 
ter., 59;  centrale  retinae,  501;  cce- 
cum,  49;  c.  linguae,  429;  condy- 
loidea,  47 ;  cribrosa,  49 ;  ethmoida- 
lia,  49,  50;  incisivum ,  59 ;  infraor- 
bitale,  59  ;  interruptum,  48  ;  inter- 
vertebralia,  75;  jugulare,  47;  lace- 
rum  anter.  poster.,  52,  bis,  57 ; 
magnum  occipitale,  47;  mastoid., 
52 ;  maxillare  (poster.),  66 ;  Mei- 
bomii  s.  ccecum  linguae,  mentale, 
66 ;  Monroi,  620 ;  obturatorium, 
92  ;  O3sophageum,  266;  opticum,  48 
bis  ;  or  bit  alia  s.  ethmoid.,  ovale,  48, 
92  ;  ov.  cordis,  528 ;  parietale,  51  ; 
pterygo-spinosum,  48;  quadrilate- 
rum,  266  ;  rotundum,  48  ;  spheno- 
palatin.,  60  ;  spinale,  75  ;  spinosum, 
48;  stylomastoid.,  52;  supraorbi- 
tale,  50;  Thebesn,  528;  vertebrale, 
77;  Winslowii,  452;  zygomatic.,  61. 


Fornix,  619  ;  cranii,  57 ;  vaginae,  487. 

Fossae  :  articulares  patellae,.  105 ; 
(bulbi  v.)  jugular.,  47;  cerebelli, 
47;  cerebrum,  47;  condyloideae, 
47 ;  cochlea,  52 ;  cranii,  57  ;  cubiti 
s.  sigmoid. ;  ductus  venosi,  445  ; 
gland,  lacrymal.,  50 ;  humeri,  96  ; 
hyalpidea,  504;  iliaca,  93,  699 ;  ilio- 
pectinea,  365  ;  infra  -  clavicular. , 
703 ;  infraspinata,  94 ;  inguinalis, 
453;  innominata,  506;  intercondy- 
loideae,  102;  lacrymal.,  63;  longi- 
tudin.  hepat.,  445;  malleoli,  104; 

•  pro  medulla  obi.,  47 ;  Morgagni, 
473;  navicular.,  473,  488;  auris  s. 
scapha :  ovalis,  528  ;  parietalis,  51 ; 
perinaei,  282 ;  poplitaea,  102,  705 ; 
pterygoidea,  48;  pterygo-palatina, 
72;  pulmonales,  87  bis  ;  sigmoidea, 
98;  spheno-maxillar.,  72;  supra- 
clavicular.,  211 ;  supraspinata,  94  ; 
Sylvii,  615;  temporales,  57;  trans- 
versa  hepatis  s.  porta ;  trochante- 
rica,  102 ;  trochlearis,  50 ;  umbili- 
calis,  v.  cavae :  vesicae  fell.,  445  ; 
vestibuli,  super.,  infer.,  52;  zygo- 
matica,  71,  690. 

Fossula  petrosa,  52. 

Foveae :  acetabuli,  92 ;  axillaris,  702 ; 
inguinales,  453 ;  lacrymal.,  50,  68  ; 
maxillaris,  59  ;  ovalis,  365. 

Frenula:  clitoridis,  488;  labiorum, 
428,  488  ;  linguae,  429 ;  Morgagni, 
440  ;  valvul.  cerebell.  anter.,  622. 

Funiculus  spermaticus,  478 ;  umbili- 
calis  s.  art.  and  ven.  umbilic. 


G. 

Galea  aponeurotica,  150. 

Ganglia,  611;  Arnoldi,  637;  auricu- 
lare,  637 ;  cardiacum,  672,  673,  674 ; 
caroticum,  672;  cerebri,  620;  cer- 
vicalia,  671,  673,  674;  ciliare,  635; 
coccygeum,  678 ;  Casseri,  634 ; 
geniculatum,  639  ;  glotticum,  637 ; 
incisivum,  636  ;  intercaroticum, 
672  ;  jugularia  :  Mulleri,  641 ;  n. 
vagi,  643  ;  linguale,  637 ;  lumbalia, 
676 ;  maxillare,  637 ;  Meckelii,  636  ; 
naso  -  palatinum,  636;  ophthalmi- 
cum,  635;  oticum,  637;  petrosum, 
636  ;  rhinicum,  636  ;  sacralia,  677  ; 
semilunare,  680;  sphenopalatinum, 
636  ;  spinalia,  649  ;  temporale,  672; 
thoracica,  675  ;  thyreoideum,  673. 

Genae,  428. 

Genetalia  muliebra,  483  ;  virilia,  475 


478 


INDEX. 


Genu  corpor.  callosi,  619 ;  n.  facial., 
639. 

Gingiva,  432. 

Ginglymus,  45. 

Glabella,  50. 

Glandebalae,  26. 

Glandulae,  37;  Bartholinianae,  488; 
Brunnerian,  438  ;  buccales,  428  ; 
ceruminos,  507;  Cowperi,  479,  488  ; 
Duverneianae,  488 ;  epiglottica,  462, 
464;  Haversian,  110;  labiales,  428  ; 
lacrymales,  494  ;  lactiferae  s.  mam- 
mae ;  lenticular,  ventric.,  436  ;  Lie- 
berkiihn.,  438;  Littrii,  473;  Mei- 
bomii,  493  ;  mucosae,  37  ;  molares, 
428;  odoriferae  s.  Tysonianae,  482; 
palatine,  428;  parotis,  430;  Pey- 
erian,  438 ;  pinealis,  619 ;  pituitaria, 
618;  praeputiales,  482;  prostata, 
480;  solitaries  intestinal.,  438,  439; 
salivales,  430;  sublingualis,  430; 
submaxillar,  430 ;  suprarenales, 
474;  tartaricae,  37;  thymus,  469; 
thyreoidea,  465 ;  tracheales,  466  ; 
tubulosee,  37. 

Glandulss  lymphatics  :  aorticae,  603 ; 
axillares,  605;  brachiales,  605; 
bronchiales,  605  ;  cervicales,  605  ; 
cceliacse,  604  ;  cubitales,  605  ;  duo- 
denales,  604 ;  faciales,  605 ;  gas- 
tro-epiploicae,  604  ;  hepaticse,  604  : 
hypogastricae,  603;  iliacae  extern., 
603;  inguinales,  603;  intercostales, 
605  ;  Littrii,  473  ;  lienales,  604 ; 
lumbales,  603 ;  mastoideae,  605 ; 
maxillares  internee  s.  submaxillar., 
605;  mediastinse  anter.  et  post., 
605 ;  mesentericae,  604 ;  mesoco- 
licae,  604 ;  occipitales,  605 ;  pan- 
creatic, 604;  parotidae,  605;  popli- 
teae,  603;  pulmonicae,  605;  sacrales, 
603 ;  subauriculares,  605 ;  sub- 
maxill.,  605 ;  substernales,  605 ; 
tracheales  s.  bronchiales ;  tibialis 
antic.,  603;  Vesalian,  605;  zygo- 
maticae,  605. 

Glans  clitorid.,  488;  penis,  482. 

Glomeruli  Malpighii,  470. 

Glottis,  463. 

Gubernaculum  Hunteri,  477. 

Gyri  breves,  615  ;  gyrus  fornicatus, 
615,  623. 


H. 


Habercula,  478. 
Hallux,  108. 

Hamulus  lacrymal.,  63 ;  oss.  hamati, 
99 ;  pterygoid,  48. 


Harmonia,  45. 

Helix,  506. 

Hemisphaeria  cerebri,  614 ;  cerebelli, 

616. 

Hepar,  445. 
Hiatus  aorticus,  266 ;  canal.  Fallop., 

52. 
Hilus  lienis,  451 ;   ovarii,  483 ;   pul- 

mon.,  467;  renis,  470. 
Hippocampus,  620. 
Histologia,  1. 
Humerus,  94. 

Humor  aqueus,  502 ;  vitreus,  504. 
Hymen,  487. 
Hypogastrium,  699. 
Hypophysis  cerebri,  618. 


I. 


Jecur,  445. 

Jejunum,  440. 

Ileum,  440. 

Impressiones  digitatae,  s.  cranium. 

Incisurae :    ischiadica    major,    minor, 

91 ;     pterygoidea,    48 ;     Santorini, 

507;  sigmoidea,  66 ;  supraorbitalis, 

50. 

Incus,  510. 
Index,  101. 

Infundibulum,  471 ;  inf.  cerebri,  618. 
Inscriptiones  tendineae  s.   m.   rectus 

abdom. 
Insula,  615. 

Integumenta  communia,  38,  39. 
Intercilia,  491. 
Interstitium  jugulare,  692. 
Intestinum  amplum  s.  crassum,  441 ; 

augustum  s.  tenue,  438. 
Introitus  vaginae,  487. 
Intumescentia  ganglioform.  n.  facial, 

639. 

Iris,  500. 

Irritabilitas  Halleri,  143. 
Isthmus  faucium,  428 ;  urethrae,  473 ; 

Vieussenii,  528. 
Juga  alveolaria,   59,  66;   cerebralia, 

51. 

Jugulum,  692. 
Julus,  428. 
Junctura  ossium,  45. 


L. 


Labia,  428 ;  orificii  uteri,  486 ;  pu- 
dendi  majora,  488 ;  minora,  488. 

Labra:  glenoidea  s.  cartil.,  110;  ace- 
tabuli,  129 ;  humeri,  120. 


INDEX. 


479 


Labyrinthus  membranaceus,  515;  os- 
seus,  512;  oss.  ethmoid.,  49. 

Lacertus  Weitbrechti,  112. 

Lacinice  plantares,  395;  1.  s.  fimbr. 
tub.  Fallop.,  485. 

Lacunae  s.  cryptae,  473. 

Lacunar  orbitae,  68. 

Lacus  lacrymalis,  494. 

Lamella?  ossium,  42. 

Laminae:  cribrosa  cerebri,  618;  fasc. 
femoris,  365;  oss.  ethmoid.,  49; 
scleroticae,  497;  papyracea,  49;  spi- 
ralis,  514;  terminalis,  514;  vitrea, 
57. 

Lanugo,  26. 

Laqueus,  623. 

Larynx,  461. 

Lema,  493. 

Lemniscus  s.  corp.  ciliare  cerebelli. 

Lens  crystallina,  503. 

Lien,  451. 

Lienculus,  451. 

Ligamenta,  110;  accessor,  obliquum, 
rectum  Weitbrecht,  112;  alaria 
genu,  130;  Maucharti,  112;  api- 
cum,  111  ;  arcuatum,  117;  arterio- 
sum,  535;  ary-epiglottica,  463 ;  au- 
riculas, 506  ;  capsulare  sacciforme, 
122  bis;  ciliare,  499;  conoideum, 
119;  coronar.  hepatis,  455;  corus- 
cantia,  116;  crico-arytaenoid.,  463; 
-thyreoid.,  463;  -tracheal.,  463; 
crucial,  atlantis,  113;  -digitorum, 
336;  -genu,  130;  tarsi,  381;  del- 
toideum,  132;  denticulatum,  628; 
duodeno-colicum,  d.-renale  s.  peri- 
toneum ;  Epididymis,  477 ;  Fallo- 
piae,  256;  flava,  111;  fundiforme 
tarsi,  381 ;  gastro-colicum,  gastro- 
hepaticum,  gastro-lienale  s.  perito- 
naeurn  ;  Gimbernati,  257  ;  glenoi- 
deum,  120;  glosso-epiglottica,  464 ; 
glottidis,  463;  hepatico-colicum, 
-duodenale,  -gastricum,  -renale  s. 
peritonaeum,  Hunteri  s.  Guberna- 
cul. ;  hyo-epiglotticum,  462;  hyo- 
thyreoidea,  463;  ilio-lumbalia,  117; 
ilio-pectineum  s.  fasc.  iliaca ;  ilio- 
sacra,  117;  inguinale  s.  fasc.  trans- 
vers. ;  intercartilaginea  s.  cartil. ; 
intervertebr.,  Ill  ;  interlobularia, 
468;  intertransversalia,  111;  laci- 
niata,  383 ;  laryngis,  463 ;  longitu- 
dinale  anter.,  Ill  ;  poster.,  Ill  ; 
mallei,  510 ;  mucosa  genu,  130 ; 
nuchaB,  111;  obturatorium,  117; 
obt.  atlant.,  112;  ossicul.  auditus, 
510;  ovarii,  483;  palpebralia,  492 ; 
patellas,  130;  phrenico  -  gastrica, 


-lienale  s.  peritonasum;  pelvis,  117; 
perinaeale,  283;  poplitaeum,  130; 
Poupartii,  256;  pubo  -  prostatica, 
482;  -vesicalia,  284,  472;  pulmonis, 
468;  pyramidalia  s.  artic.  carpi; 
radiatum  extern.,  116;  rhomboid, 
carpi,  123;  clavicute,  118,  119: 
sacro-coccygea,  117;  sacro-ischia- 
dica,  117  ;  serosa  s.  periton.,  serra- 
tum,  628  ;  spinoso- sacrum,  117 ; 
stylo-hyoideum  s.  muse.  ;  stylo- 
maxillare,  114;  subcruentum,  122 
bis  ;  subflaya,  111 ;  suspens.  dentis, 
112;  -penis,  482;  -hepatis,  445; 
-vesicffi,  453 ;  triangularia,  455 ; 
teres,  129,  445;  trapezoideum,  119; 
tuberoso-sacrum,  117;  uteri  lata, 
486;  -rotunda,  486;  vaga,  117; 
Valsalvae,  506 ;  vesicalia,  472 ;  vo- 
calia,  463. 

Limbus  alveolaris  s.  process,  alv.,  66. 

Lineae  :  alba,  261 ;  arcuatae,  90 ;  as- 
pera,  102;  intertrochanterica,  102; 
semicircularis,  47,  50,  51,  57;  ob- 
liquae,  66,  462;  transversae  occi- 
pitis,  47;  palat.,  60;  turbinata,  59. 

Lingua,  429.  • 

Lingula,  622. 

Liquor  sanguinis  et  lymphae,  33. 

Liquor  Morgagni,  503. 

Lobulus  anonymus  hepatis,  445  ;  au- 
riculas, 506 ;  biventer  s.  cerebel- 
lum ;  caudatus  s.  quadratus,  445 ; 
Spigelii  s.  hepar  ;  tener  s.  cere- 
bellum. 

Loculamenta,  442. 

Lunula,  23. 

Lympha,  34. 

Lyra,  619. 


M. 

Maculae  cribrosae,  512;  lutea,  501; 
germinativa,  484. 

Malleolus  extern.,  104;  intern.,  103. 

Malleus,  510. 

Mammae,  489. 

Mandibula,  66. 

Manubrium  mallei,  510;  sterni,  84. 

Manus,  99. 

Margo  ciliaris  iridis.  500. 

Massa  explementi,  623. 

Massae  laterales,  77. 

Matrix  pili,  26  ;  unguis,  23. 

Maxilla  inferior,  66  ;  super.,  59. 

Meatus  auditor,  extern.,  52,  507;  in- 
tern.. 52;  narium,  519. 

Mediastina,  468. 


480 


INDEX. 


Meditullium  album,  623. 

Medulla  oblongata,  618 ;  ossium,  42  ; 
spinalis,  627. 

Membranae :  adamantina,  431  ;  cap- 
sulo  -  pupillaris,  503  ;  Descemetii, 
498  ;  fenestrae  rotundae,  509  ;  gra- 
nulosa,  484 ;  humor,  aquei,  498 ; 
hyaloidea,  504 ;  interpssea  cruris, 
131 ;  medullaris,  42 ;  niciitans,  492 ; 
obturatoria  s.  Ligg. ;  oss.  sacri  pro- 
pria,  117  ;  pigmenti,  499 ;  pituitaria, 
519;  pulposa  palati,  428 ;  pupillaris, 
503;  Ruyschiana,  499;  Schneideri- 
ana,  519;  sterna  propria,  116;  su- 
prachoroidea,  498  ;  thyreohyoidea 
s.  lig. ;  tympani,  508  ;  secundaria, 
509 ;  vitellina  s.  chorion ;  Wachen- 
dorfiana,  503. 

Membrum  virile,  482. 

Menisci,  114. 

Meninx  arachnoidea,  624  ;  dura,  624 ; 
pia,  624. 

Mentum,  66. 

Mesencephalon,  617. 

Mesenteriolum  appendicis,  442;  tes- 
ticuli  s.  mesorchium. 

Mesenterium,  459. 

Mesocoecum,  459. 

Mesocolpn,  459 ;  -transvers.,  458. 

Mesorchium,  477. 

Mesorectum,  459. 

Metacarpus,  100. 

Metatarsus,  107. 

Modiolus,  514. 

Mons  cerebelli,  622;  Veneris,  482, 488. 

Monticulus  cerebelli,  622. 

Mordices  s.  dentes. 

Morsus  diaboli,  485. 

Mucro  cordis,  527 ;  sterni,  84. 

Musculi,  141. 

A.  abdominales,   253,   254,  255, 
262,  263  ;  abducens,  oculi,  495  ; 
abductor    digit,    minimi.    326, 
389 ;     hallucis,   385  ;    pollicis, 

,  315,    322  ;    accelerator    urinae, 

277;  adducens  oculi,  495;  ad- 
ductores  femor.,  357,  358,  359, 
360 ;  hallucis,  387 ;  pollicis, 
325 ;  amatorius,  495  ;  anconaei, 
295,  296  ;  aniscalptor  s.  aniter- 
sor,  222;  antagonistae,  145;  an- 
titragicus,  154,  506 ;  ary-epi- 
glotticus,  arytaenoid.,  464;  at- 
tollens  auricul.,  151  ;  humeri, 
285  ;  oculi,  495  ;  auriculares, 
151 ;  azygos  uvulae,  200. 

B.  baseo-glossus,  194;  bibitorius, 
495 ;  biceps  brachii,  292 ;  femo- 
ris,  350  ;  biventer  cervic.,  232  ; 


maxillae,  188;  brachialis intern., 
293;  extern.,  295;  buccinator, 
163  ;  bucco-pharyngeus,  196  ; 
bulbp-cavernos.,  277. 

C.  caninus,  166  ;  capitis,  149 ;  ce- 
rato-glossus,  194;    cerato-pha- 
ryngeus,    196  ;     cervical,    de- 
scend., 236  ;    chondro-glossus- 
pharyng.,   194,   196;    circumfl. 
palati,    199;    cpccygeus,    272; 
complex,    cervic.,    233  ;    com- 
pressor narium,  159;  constric- 
tor cunni,  278  ;  isthmifaucium, 
201 ;  pharyngis,  196  ;  urethrae, 
277  ;     coraco-brachialis,    294  ; 
-ceryicalis,  185  ;  corrugator  su- 
perciliaris,  156 ;  costo-ciavicu- 
lar.,  214;  cremaster,  264 ;  cri- 
co-arytaenoid.,  -thyreoid.,  464; 
-pharyngeus,  196 ;  crotaphytes, 
175  ;  cruralis,  355  ;  cucullaris, 
221 ;  curvator  coccygis,  273. 

D.  deltoideus,  285  ;  depressor  alas 
nasi,    158 ;    anguli    oris,    169 ; 
labii  inferior.,  171 ;  septi  mobil., 
162 ;    vesicae,  280  ;   digastricus 
maxill.,  188;  dilat ores  narium, 
160 ;  conchae,  506. 

E.  ejaculator.  semin.  s.  accelera- 
tor ;    epicranius,    149 ;    erector 
clitorid.,  penis,  276;  extensores 
carpi,  309_,  310  ;  coccygis,  274  ; 
cruris,  355  ;    -digitorum  com- 
mun.312,  368;  digit,  min.,  313  ; 
dorsi,  237;    halluc.,  367,  378, 
384  ;  indicis,  318 ;  pollicis,  316, 
317. 

F.  fascialis,  353 ;   flexores  carpi, 
301,    303;    digitor.    commun., 
304,  305,  377,  391 ;  digit,  min., 
327,  390  ;  femoris,  337 ;  fibula- 
ris,  350 ;  hallucis,  386  ;  pollicis, 
306,  324;  radii,  292;  frontalis, 
150. 

G.  gastrocnemius,  372;  gemelli, 
345,  346;    genio-glossus,  195; 
-hyoideus,    191 ;    -pharyngeus, 
196;  glosso-palatin.,  201  ;  glu- 
taei,  340,  341,  342  ;  gracilis,  356. 

H.  helicis,  506  ;  hippicus,  366 ; 
Hprneri,  494;  hyo-glossus,  194. 

I.  iliacus,  338  ;  ilio-costalis,  238 ; 
incisivi,  158,  172 ;  indicator, 
318;  infracostales,  217;  in- 
fraspinat.,  287;  intercostales, 
216;  interossei,  331,  332,  394, 
395  ;  interspinales,  249  ;  inter- 
transversales,  250 ;  ischio-ca- 
vernos.,  271 ;  -coccyg.,  272. 


INDEX. 


481 


L.  latissim.  colli,  182 ;  dorsi,  222 ; 
laxator  tympani,  510;  levator 
anguli  oris,  166  ;  -scapulae,  226 ; 
-ani,  275  ;  costarum,  243  ;  -labii 
super.,  164,  165;  -menti,  172 ; 
-palpebrae,  157;  -palati,  198; 
penis,  276;  -pharyng.,  197; 
linguales,  192  ;  longissim.  dor- 
si,  237 ;  longus  colli,  203 ;  lum- 
bricales,  330,  393. 

M.  mallei,  510;  mansores,  174; 
masseter,  174;  multifidus,  248; 
mylo-hyoideus,  190  ;  -pharyn- 
geus,  196. 

N.  nauticus,  376  ;  nutator  capitis, 
183. 

O.  obliqui  abdomin.,  253,  254; 
capitis,  246,  247;  oculi,  495; 
obturatores,  344,  345  ;  occipit., 
149 ;  omohyoideus,  185 ;  orbi- 
cularis  oris,  162 ;  palpebrar., 
155 ;  opponens  digit,  min.,  328 ; 
pollic.,  323. 

P.  palato-staphylin.,200;  palma- 
ris  brevis,  329 ;  longus,  302 ; 
papillaris,  528 ;  patheticus,  495 ; 
pectinaeus,  357 ;  pectorales, 
212,  213;  pediaeus,  384;  peri- 
naeus,  271 ;  peristaphylini,  198; 
peronei,  369,  370,  371 ;  pharyn- 
gei,  196 ;  pharyngo-palatinus, 
202 ;  pyriformis,  343 ;  plantaris, 
373;  platysmamyoid.,  182;  po- 
plitaeus,  375  ;  procerus,  161  ; 
pronator  quad.,  307;  teres, 
300 ;  protractor  s.  sphincter  ani ; 
protrahens  auricul.,  152;  psoas 
major,  minor,  337,  338 ;  ptery- 
goidei,  176,  177;  pterygo-pha- 
ryngeus.  196 ;  pubo-caverno- 
sus,  277 ;  pyramidalis,  161,  263. 

Q.  quadratus  femor.,  347;  lum- 

borum,  265;  menti,  171. 
R.  radialis  intern.,  301,  309  ;  bre- 
vis, 310;  longus,  309;  rectus 
abdominis,  262 ;  recti  capitis, 
204,  205,  206,  244,  245 :  -femo- 
ris,  355 ;  -internus  s.  gracilis ; 
-pculi,  495 ;  reflector  epiglot- 
tid.,  464 ;  rhomboidei,  227,  228; 
retrahentes  auriculas,  153;  ri- 
sorius,  170  ;  rotatores  dorsi, 
251. 

S.  sacci  lacrymalis,  494 ;  sacro- 
coccygei,  273,  274 ;  sacro-lum- 
balis  s.  ilio-costalis ;  sartorius, 
354 ;  scaleni,  207,  208,  209 ;  se- 
mimembranos.,  352 ;  semi-spi- 
nalis  cervicis,  242 ;  -dorsi,  241 ; 


semitendinosus.  351  ;  serrati 
antici,  215;  postici,  229,  230; 
soleus,  374 ;  spheno-salpingo- 
staphylin.,  199  ;  sphincter  ani, 
270;  -oris,  162;  -palpebrarurn, 
155 ;  spinalis  cervicis,  240 ; 
dorsi,  239 ;  splenius  capitis, 
224 ;  colli,  225 ;  sternocleido- 
mastoideus,  183  ;  sternohyoi- 
deus,  184;  -thyreoideus,  186; 
stylo-glossus,  193 ;  stylo-hy- 
oid.,  189  ;  stylo  -  pharyngeus, 
197 ;  subanconeus,  297  ;  sub- 
clavius,  214  ;  subcpstales  s.  in- 
fracost. ;  subcruralis,  355 ;  sub- 
scapularis,  290 ;  superbus,  495 ; 
supinatores,  308, 311 ;  supracos- 
tales  s.  levatores  cost. ;  supra- 
spinatus,  286. 

T.  temporalis,  175 ;  tensor  fasciae 
lat.,  353;  palati,  199;  teretes, 
288,  289;  tibialis  antic.,  366; 
postic.,  376;  thyreo-arytaenoid., 
464;  -hyoideus,  187;  thyreoi- 
deus, 187;  thyreo-pharyngeus, 
196;  trachelo-mastoid.,  234; 
tragicus,  506;  transversal,  cer- 
vicis, 235;  menti,  173;  pedis, 
388;  transversus abdomin.,  255; 
auriculae,  506 ;  mandibulae,  190; 
nasi,  159 ;  perinaei,  271 ;  pros- 
tatae,  480 ;  trapezius,  221 ;  tri- 
angularis  menti,  169 ;  sterni, 
218;  triceps  brachii,  295 ;  femo- 
ris,  358  ;  surae,  372. 
U.  ulnaris  extern.,  314;  intern., 

303. 

V.  vasti,  355 ;  vesicales,  280. 
Z.  zygomatici,  167,  168. 

Mutatio  dentium,  433. 

Myologia,  141. 

Mystax,  428. 


N. 

Nares,  517. 

Nasus,  516. 

Nates  s.  clunes. 

Nervi,  611. 

A.  abducens,  638 ;  accessories 
Willisii,  647;  acusticus  s.  audi- 
torius,  640;  alveolar,  anter., 
636;  infer.,  637;  poster.,  636; 
super.,  636;  auricularis  ante- 
rior, 637;  magnus,  653;  n.vagi, 
643 ;  poster.,  639  ;  superior, 
653  ;  auriculo-temporalis,  637 ; 
axillaris,  660. 


482 


INDEX. 


B.  brachiales,  658 ;  buccales,  639 ; 
buccinatorius,  637, 

C.  cardiac!  sympathici,  672,  673, 
674 ;  vagi,  644,  645 ;  carotico- 
tympanici,  671 ;  caroticus,  671 ; 
cerebrales,  629 ;  cervicales,  650; 
ciliares,  635  ;  circumflexus  hu- 
meri,  660 ;  coccygei,  668 ;  coch- 
leae,   515,   640  ;    communicans 
faciei,  639;  fibul.,  667;  tibiae, 
667 ;    communicantes  faciales, 
639  ;     crotaphitico  -  buccinator, 
637 ;    cruralis,   665  ;    cubitalis, 
660;   cutanei  abdominis,   661; 
antibrachii,  659;  brachii,  659; 
cruris,  667 ;   dorsi  pedis.  667 ; 
femoris,  665,  667;  glutasi,  667; 
pectoris,  661. 

D.  dentales,  636,  637 ;  diaphrag- 
maticus,  654;  digastricus,  639; 
divisus,    634;    dorsales,    661; 
•clitoridis  penis,  667;  -scapulae, 
657. 

E.  ethmoidalis,  635. 

F.  facialis,   639;    faciales,   639; 
femoralis,  665  ;  fibularis,  667 ; 

^frontales,  635. 

G.  genito-cruralis,   664 ;   glosso- 
pharyngeus,  641 ;  glutaei,  667  ; 
gustatorius,  637. 

H.  haemorrhoidales,  667 ;  hypo- 
glossus,  648. 

I.  ileo-hypogastricus,  664;  ileo- 
inguinalis,  664;  indignatorius, 
639  ;  infra-occipitalis,  653  ;  in- 
fraorbitalis,  636  ;  infrascapula- 
ris,  657;  infraspinatus,  657;  in- 
fratrochlearis,  635 ;  inguinalis, 

664  ;    intercostales,   649,   661 ; 
interossei,  660;  ischiadicus,  667; 
Jacobsonii,  641 ;  jugularis,  671. 

L.  labiales,  636,  667;  lacryrnalis, 
635 ;  laryngei,  644,  645 ;  lin- 
gualis,  637,  641;  lumbales,  662; 
lumbo-inguinales,  664. 

M.  mandibularis,637;  marginalis, 
639;  massetericus,  637;  masti- 
catorii,  637;  maxillaris  supe- 
rior, 636  ;  maxillar.  infer.,  637; 
meatus  auditorius  extern.,  367; 
,  medianus,  660  ;  mentalis,  637  ; 
molles,  672;  muscularis,  660, 

665  ;    musculo-cutaneus,   659  ; 
mylohyoideus,  637. 

N.  nasales,  635,  636  bis ;  naso- 
ciliaris,  635  ;  naso  -  palatinus, 
Scarpae,  636. 

O.  obturatorius,  665;  occipitales, 
652,  653  ;  oculo-motorius,  632  ; 


cesophagei,  645  ;  olfactorius, 
630  ;  ophthalmicus,  635  ;  opti- 
cus,  631. 

P.  palatini,  636 ;  palpebrales,  636; 
patheticus,  633 ;  pectorales,657, 
661 ;  perforans  Casserii,  659  ; 
perinaei,  667;  peronei,  667;  pe- 
trosi,  636,  641,  671 ;  pharyngei, 

644  ;  phrenici,  654  ;   plantares, 
667;  pneumogastricus,  642;  pop- 
litaei,   667  ;    pterygoidei,    637  ; 
pterygo-palatinus,  636  ;  puden- 
di,  667. 

R.  radialis,  660;  recurrens,  636, 

645  ;   renales,   679  ;    respirato- 
rius,  657. 

S.  sacrales,  666;  sapheni,  665, 
667;  scapularis,  657;  scrotales, 
667  ;  septi  narium,  636  ;  sper- 
maticus,  664,  667;  sphenopa- 
latinus,  636  ;  spinales,  649  ; 
splanchnici,  679  ;  subclavius, 
654  ;  subcutanei :  colli,  653  ; 
clunium,  667  ;  femoris,  667 ; 
glutffiii,  667;  malae,  636;  max- 
illae infer.,  637;  nasi,  636;  peri- 
naei, 667  ;  suboccipitalis,  651 ; 
subscapularis,  657 ;  supracla- 
viculares,  654 ;  supraorbitalis, 
635  ;  suprascapularis,  657 ;  su- 
praspinatus,  657 ;  supratroch- 
learis,  635  ;  sympathicus,  669. 
T.  temporales,  637  bis ;  tentorii 
cerebelli,  633;  thoracici,  657, 
661 ;  tibiales,  667 ;  tracheales, 
645 ;  trigeminus,  634 ;  troch- 
learus,  633 ;  tympanicus,  637, 
641. 

U.  ulnaris,  660. 
V.    vagus,    642  ;   vestibuli,   515, 

640;  vidiani,  636,  671. 
Z.  zygomatici,  635,  639. 
Neurilema,  29,  611. 
Neurologia,  606. 
Nodulus    Arantii,   528 ;    Malacarne, 

622. 

Nucleus  caudatus,  623;  cerebelli,  623; 
dentis,  432 ;  lenticularis,  623 ;  len- 
ds, 503  ;  taeniasformis,  623. 
Nymphae,  488. 


O. 

Occiput,  47. 

Oculus,  490. 

(Esophagus,  435. 

Olecranon,  97. 

Omentum  majus,  457  ;  minus,  457. 


INDEX. 


483 


Omoplata,  94. 

Ora  serrata,  504. 

Orbiculus  ciliaris,  499. 

Orbita,  68. 

Orchides,  477. 

Organa :  auditus,  505  ;  digestionis, 
427 ;  genitalia,  475  ;  gustus,  429 ; 
lacrymalia,  494;  olfactus,  516;  res- 
pirationis,  460;  sensoria,  490;  sudo- 
ripara,  39;  uropoetica,  470;  visus, 
490;  vocis,  461. 

Os,  428;  tincae,  486. 

Ossa,  41;  antibrachii,  97;  basilare, 
47 ;  brachii,  96 ;  bregmatis,  51 ; 
capitatum,  99:  capitis,  46;  coxae, 
89  ;  coccygis,  80 ;  cranii,  46  ;  cri- 
briforme,  49;  cruris,  103;  cuboi- 
deum,  106 ;  cuneiformia,  106 ;  cy- 
lindrica,  41;  ethmoideum,  49;  fa- 
ciei,  58;  femoris,  102;  frontale,  50; 
hamatum,  99 ;  humeri,  96 ;  hyoi- 
deum,  67;  ilium,  90;  innominata, 
88 ;  intermaxillare  s.  incisivum,  59 ; 
ischii,  91 ;  jugale,  61 ;  lacrymale, 
63 ;  linguale,  67  ;  lunatum,  99  ;  ma- 
lare,  61 ;  manus,  99;  maxillare,  59, 
66;  multangulum  majus,  99;  mi- 
nus, 99  ;  nasalia,  62  ;  naviculare. 
99,  106 ;  occipitis,  47 ;  palatina,  60 ; 
parietalia,  51;  pectoris,  84;  pedis, 
106;  petrosum,  52  ;  pisifbrme,  99  ; 
pubis,  92;  pyramidale,  99;  sacrum, 
79 ;  scaphoideum,  99,  106 ;  sesa- 
moidea,  101,  108;  sphenoidea,  48; 
temporum,  52;  trapezoides,  99;  tri- 
quetrum,  99;  turbinata,  64;  unci- 
forme  s.  hamatum ;  unguis,  63 ;  zy- 
gomatica,  61. 

Ossicula  auditus,  510;  Bertini,  48; 
episternalia,  84;  lenticulare,  Sylvii, 
510;  Wormiana,  47. 

Osteogenesis,  43. 

Osteologia,  41. 

Otoconia  s.  otolithi,  515. 

Ovaria,  483. 

Ovula  Nabothi,  486;  Graafiana  s. 
vesicul. 

Ovulum,  484. 


P. 


Palatum  durum,  428 ;  mobile,  428. 

Falpebrae,  492. 

Pancreas,  450. 

Panniculus  adiposus,  30. 

Papillae  calicinae,  capitatae,  clavatae, 
conicae,  429 ;  corii,  39 ;  filiformes, 
fungiformes,  429 ;  foliata,  429 ;  len- 


ticulares,  429 ;  linguae,  429  ;  mam- 
mas, 489;  renalis,  470;  truncatae, 
vallatae,  429. 

Pappus,  428. 

Parastata,  477. 

Parotis,  430. 
j  Patella,  105. 
:  Pecten,  92. 
!  Pectus,  83. 

Pedunculi  cerebri,  623. 

Pelvis,  88,  93;  renalis,  471. 

Penis,  482. 

Pericardium,  530. 

Perichondrium,  29,  32. 

Pericranium,  57. 

Periglottis,  429. 

Perimysium,  142. 

Perinaeum,  701. 

Periorbita,  68. 

Periosteum,  29,  42. 

Peritoneum,  452. 

Perone  s.  fibula. 

Pes,  106 ;  anserinus,  351 ;  hippocampi 
major,  620  ;  minor,  620. 

Phalanges,  101, 108. 

Pharynx,  434. 

Philtrum,  428. 

Pia  mater,  29,  626,  628. 

Pigmentum  nigrum  s.  acinosum,  24. 

Pili,  26. 

Pinguedines,  12. 

Pinnaj  nasi,  517. 

Placenta  lymphae  et  sanguinis,  35,  36. 

Planum  semicirculare,  51. 

Pleura,  468. 

Plexus  :  anserinus  s.  nerv.  facial. ; 
lymphatici  s.  vasa  lymphat.,  601 ; 
venosus  pampiniform.,  596 ;  spi- 
nales,  600. 

Plicae  conniventes  Kerkring.,  438 ; 
cubiti,  704;  inguinalis,  699  bis; 
palmatae,  486  ;  pubo  -  umbilicales, 
453 ;  recto-uterin.  s.  periton. ;  semi- 
lunaris  conjunctiv.,  492 ;  Douglas,  s. 
periton.;  urachi,  453;  uretericae, 
472;  vesico-uterin.  s.  periton. 

Pollex,  101. 

Pomum  Adami,  462. 

Pons  Sylvii,  619 ;  Varolii,  618. 

Porta  hepatis,  445. 

Portio  dura,  639  ;  mollis  n.  vii.,  640; 
intermed.  Wrisberg.  s.  nerv.  faci- 
alis,  639. 

Porus  acusticus  s.  meatus  auditor. 

Praeputium  clitorid.,  488  ;  penis,  482. 

Processus  :  alveolaris,  59;  anconaeus, 
97;  anonymus,  47;  ciliares,  499; 
clinoidei,  48,  57 ;  cochlearis,  509 ; 
condyloid.,  47,  66 ;  coracoideus,  94  ; 


484 


INDEX. 


coronoideus  maxill.,66;  ulnae,  97; 
cubitalis  s.  ancon.,  97;  ensiformis, 
48,  84 ;  ethmoidalis,  65 ;  folianus, 
510;  falciform,  major  et  minor,  624; 
fascia?  latae,  365 ;  frontalis  maxill. 
sup.,  59  ;  oss.  zygomatic.,  61 ;  geni, 
66;  incudis,  510;  jugularis,  47;  lac- 
rymalis,  64 ;  mallei,  510 ;  riiammil- 
laris,  s.  mastoideus,  52;  maxillar., 
64  ;  nasalis,  59  ;  obliqui,  75  ;  odon- 
toideus,  77 ;  orbitalis,  60 ;  oss.  zy- 
gomat.,  59  ;  palatinus,  59 ;  pterygoi- 
deus,  48 ;  pyramidalis,  60 ;  sphenoi- 
dal.,  60;  spinosus,  48,  75,  76  ;  sty- 
loidei,  52,  97,  98 ;  temporalis,  61 ; 
transversi,  75,  76  ;  uncinatus,  49, 
99  ;  vermiformis,  442  ;  xyphoides, 
84  ;  zygomatici,  50,  52. 

Prolabia,  428. 

Promontorium,  79,  509. 

Pronatores,  145. 

Prostata,  480. 

Protuberantia  annularis,  616,  618  ; 
occipitalis,  47. 

Psalterium,  619. 

Ptyalin,  7. 

Pubes,  26,  476,  488. 

Pudendum,  488. 

Pulmones,  467. 

Pulpa  dentis,  lienis,  pili,  testis  (which 
see). 

Punctae  lacrymalia,  494. 

Pupilla,  500. 

Pylorus,  436. 

Pyramides  Ferreinii,  470 ;  Malpighi, 
470. 

Pyramis  vermis,  622. 


R. 


Radiatio  medullaris,  623. 

Radius,  98. 

Radix  pulmonis,  467. 

Ramus  maxill.  infer.,  66  ;  Jacobsonii, 

641. 
Raphe  corp.  callos. ;  pharyng. ;  peri- 

nse\  et  scrotii  (which  see). 
Receptaculum    chyli    seu    Pecqueti, 

601. 
Recessus  hemielliptic.,  hemispheric., 

512  ;  vesic.  urinar.  (see  these). 
Rectum,  444. 
Regio  analis,  701 ;  costalis.  694  ;  epi- 

gastrica,   696 ;    hypogastrica,   699 ; 

inguinalis,  699  bis  ;  laryngea,  692 ; 

lumbalis,  698  ;  malaris,  687 ;  mam- 

millares,  694  ;  mastoidea,  685  ;  me- 

sogastrica,  697 ;  nasalis,  686 ;  occi- 


pito-frontalis,  682;  orbital.,  689; 
parotid.,  691 ;  perinaai,  701;  sternal., 
694  ;  sterno-mast.,  693  ;  supracla- 
vicul.,  693;  suprahyoid.,  692;  thy- 
reoid.,  692;  temporal.,  683;  ton- 
sillar.,  687;  umbilical.,  697;  uro- 
genitalis,  701. 

Ren,  renulus,  470  ;  succenturiat., 
474. 

Rete  articulare  cubiti,  568 ;  carpeum 
dorsalis,  569 ;  genu,  583 ;  malleo- 
lare,  586;  Malpighii  s.  epidermis; 
mirabile,  522;  vasculos.  Haller., 
477. 

Retina,  501. 

Retinaculum  tendin.,  146. 

Rigor  mortis,  143. 

Rima  glottidis,  463  ;  valvas,  488. 

Rostrum  lamin.  spiral.,  514 ;  sphe- 
noidal.,  48. 

Rotatio,  45. 

Rotatores,  145. 

Rotula  s.  patella,  105. 

Ruga?  transvers.,  429 ;  longitudinal., 
485. 


S. 


S.  romanum,  443. 

Saccarum  lactis,  12. 

Sacculus  oblongus,  rotundus,  515. 

Saccus  epiploicus,  457 ;  lacrymal., 
494. 

Saliva,  7. 

Sanguis,  36. 

Scalae :  tympani,  vestibuli,  514. 

Scapha,  506. 

Scapula,  94. 

Scissura  longitudinal,  cerebri,  615, 
709. 

Sclerotica,  497. 

Scrobiculus  cordis,  696. 

Scrotum,  476. 

Scyphus,  514. 

Sebum  cutan.,  39. 

Sella  equina  s.  turcica,  48,  57. 

Semicanalis  tensor,  tyrnp.,  509. 

Septum  atriorum,  527 ;  cordis,  527 ; 
crurale,  364;  narium,  518;  pellu- 
cidum,  619;  penis,  482;  scroti,  476; 
ventriculorum,  528. 

Serum,  33,  35,  36. 

Sinus,  489 ;  basilaris,  625 ;  cavernosus, 
624,  625 ;  circularis  iridis,  497  ;  Rid- 
leyi,  625  ;  durae  matris,  625 ;  eth- 
moidales,  49 ;  frontales,  50;  jugulis, 
61 ;  lateralis,  625 ;  longitudinales, 
624,  625  ;  mastoidei,  52 ;  maxillaris, 


INDEX. 


485 


59;  occipitales,  624,  625;  ophthal- 
micus,  625  ;  perpendicular.,  625 ; 
petrosi,  625  ;  pterygoideus,  48 ; 
quartus  s.  rectus,  625 ;  sphenoi- 
dales,  48 ;  tarsi,  106 ;  transversus, 
624,  625 ;  ven.  portae,  445 ;  venos. 
retinae,  501 ;  vesicalis,  472. 

Situs  viscerum,  708. 

Smegma  praeputii,  482. 

Socii,  145. 

Spatium  intercostale,  694. 

Speculum  Helmpntii,  266. 

Spinae :  angularis,  48;  basilaris,  47; 
ilii,  90 ;  ischii,  91 ;  mentales,  66 ; 
nasales,  50,  59,  60;  occipitalis,  47; 
pharyngea,  47 ;  pubis,  92 ;  scapulae, 
94  ;  tibiae,  103 ;  trochlearis,  50 ;  tu- 
bercul.  maj.  et  minor.,  96;  verte- 
brarum,  74. 

Splanchnologia,  426. 

Splen  s.  lien. 

Splenium  corpor.  callos.,  619. 

Stapes,  510. 

Sternum,  84. 

Striae  :  alba,  196  ;  corneae,  620  ;  lon- 

fitudinal.,  619 ;  transvers.  Willis., 
19. 

Subiculum  coma  Ammon.,  620. 
Substantia  alba,   609,   613 ;    cinerea, 

609;   ossea,  431;   ferruginea,  623; 

periorata,  615,  618 ;  spongiosa,  41 ; 

vitrea,  431. 
Sulci :  arteriosi,  50,  51 ;  caroticus,  48, 

57;  circular,  cord.,  527. 
Sulcus  bicipit.,  96  ;  costalis,  85  ;  lac- 

Smalis,  59  ;  lateralis,  51 ;  longitu- 
nalis  cord.,  527;  cranii,  51,  57; 
humeri,  96 ;  infraorbital.,  68 ;  mento- 
labialis,  428 ;  mylo-hyoid., 66 ;  naso- 
labialis  s.  linea;  pro  n.  olfactorio, 
49;  oss.  cuboid.,  106;  palatinus, 
60;  pterygoid.,  48;  pterygo-palati- 
nus,  59 ;  transversus  cordis,  527 ; 
cranii,  47,  51,  52;  tympani,  508. 

Supercilia,  491 ;  acetabuli,  92. 

Superficies  auricularis :  lunata  acetab. 
s.  facies ;  -peronea,  103 ;  tibialis, 
104. 

Supinatores  s.  musculi. 

Sura  s.  musculi  cruris. 

Sustentaculum  tali,  106. 

Suturae,  45 ;  cranii,  54  ;  palatinae,  59, 
60 ;  transversae,  60. 

Symphysis  oss.  pubis,  92;  sacro-ilia- 
ca,  92. 

Synarthrosis,  45. 

Synchondrosis,  45. 

Syndesmologia,  110. 

Synovia,  29. 


Systema  nervosum,  606. 


T. 


Tabula  vitrea  s.  lamina,  57. 

Taenia,  620 ;  coli,  443  ;  semicircularis, 
619. 

Talus,  106. 

Tapetum,  499. 

Tarsus,  106  ;  palpebrar.,  492. 

Tegumentum  commune,  38. 

Tela  elastica,  31. 

Tendines,  146 ;  Achillis,  374 ;  exten- 
sor cruris,  355. 

Tentorium  cerebelli,  624. 

Testes,  477 ;  cerebri,  619 ;  muliebres, 
483. 

Testiculi,  477. 

Thalamus  opticus,  620. 

Theca,  484. 

Thenar,  321  bis. 

Thorax,  83. 

Tibia,  103. 

Tonsilla,  428,  621. 

Tonus,  143. 

Torcular  Herophili,  625. 

Trabeculae  carnese,  528;  cavernos., 
482. 

Trabes  cerebri  seu  corp.  callos.,  619. 

Trachea,  466. 

Tractus  foraminulentus,  514 ;  intes- 
tinalis  s.  ductus ;  olfactorius,  630 ; 
opticus,  618,  631. 

Tragi,  506. 

Tragus,  506. 

Trigonum  cervicale  infer.,  693 ;  su- 
per., 692. 

Tripus  Haileri,  572. 

Trochanter  major  and  minor,  102. 

Trochleae,  147,  335  ;  femor.,  102. 

Trochoides,  45. 

Truncus  anonymus,  540 ;  basilaris, 
555  ;  lymphaticus,  602 ;  thyreo-cer- 
vicalis,  556. 

Tuba  Eustachii,  511 ;  Fallopiae,  485. 

Tuber  calcanei  s.  calx  ;  cinereum, 
618;  cochleae,  509;  frontale,  50; 
ischii,  91 ;  maxillare,  59 ;  oss.  ilii, 
90;  naviculare,  106 ;  parietale,  51 ; 
valvulae,  622. 

Tubercular  articulare,  52;  caudatum, 
445 ;  fibula?,  104 ;  Loweri,  528 ;  pa- 
pillare,  445. 

Tuberositas  condyli  fern.,  102;  meta- 
tarsi V.,  107;  radii,  98. 

Tubuli  Belliniani,  470 ;  seminiferi, 
477;  uriniferi,  470. 

Tunicae :  adnata  oculi  s.  conjunctiva 


486 


INDEX. 


bulbi ;  testis,  477 ;  albuginea  lienis 
(which  see) ;  oculi  s.  sclerotica,  ova- 
rii,  penis,  renis,  testis  (see  these) ; 
dartos,  476 ;  erythroides  s.  m.  cre- 
master ;  Jacobi,  501 ;  nervea  s.  pro- 
pria,  29 ;  vaginalis  commun.  lestis 
et  funic.  sperm.,  478  ;  propria  funi- 
culi,  478 ;  propria  testis,  477 ;  vaso- 
rum,  523  ;  vasculosa,  29. 

Tutamina  oculi,  491. 

Tympanum,  509. 


U. 

Ulna,  97. 

Umbilicus  s.  annul,  umbilic.,  261. 

Umbo,  508. 

Uncus,  623. 

Ungues,  21. 

Urachus,  453,  472. 

Urea,  11. 

Ureter,  471. 

Urethra,  473. 

Uterus,  486. 

Utriculus  ventricular.,  515. 

Uvea,  500. 

Uvula,  428. 

V. 

Vagina,  487 ;  cruris,  379  ;  cubiti,  319  ; 
mucosffi,  148;  musculor.,  146  ;  mus- 
cui.  recti  abdom.,  269;  nervorum, 
608 ;  synoviales,  148 ;  tendinum, 
146  ;  vasor.  crural,  and  canal,  cru- 
ral., 362,  365. 

Vallecula,  52,  616,  622. 

Valvulae  :  Bauhini,  438 ;  cerebelli, 
622;  connive ntes  Kerkring.,  438; 
Eustachii,  528;  Fallopiae  s.  Bau- 
hin. ;  foram.  oval.,  528;  ileo-coeca- 
lis,  442 ;  mitralis,  528 ;  pylori,  436  ; 
semilunares  s.  sigmoideae,  528  ;  tri- 
cuspidalis  s.  triglochines,  528 ;  The- 
besii,  528 ;  Tulpii,  440  ;  vasor.  lym- 
phatic., 526 ;  venarum,  525. 

Vas  deferens,  478. 

Vasa  :  absorbentia  s.  resorbentia  ; 
aerofera,  467 ;  bronchialia,  467 ; 
capillaria,  523  ;  chylifera  s.  lact. ; 
efferentia  and  inferentia,  526  ;  ex- 
halantia,  523  ;  lactea,  604  ;  lympha- 
tica,  526,  601  ;  pulmonalia,  467, 
534 ;  resorbentia,  601  ;  sanguifera, 
521  ;  vasorum,  522  ;  vorticosa,  499. 

Vasculum  aberrans  Halleri,  477. 

Velum  medullare,  622  bis  ;  palatinum, 
428. 


VenaB,  525. 

A.  'alares,  592  ;    angularis,  592  ; 
anonym®,  591 ;  arteriosae,  536  ; 
auriculares,  592  ;  axillaris,  594  ; 
azygos,  595. 

B.  basilica,  594  ;  brachiales,  594  ; 
breves,  598. 

C.  cardiacae,  589  ;  cava  inferior, 
596  ;    superior,  590 ;   cephalica 
externa,   592  ;     interna,    592  ; 
pollicis  radialis,  594 ;  coronari® 
cordis,  589  ;  cruralis,  597. 

D.  dorsalis  penis,  597. 

F.  facialis  anterior,  592 ;  posterior, 
592;  profunda,  592;  frontalis, 
592. 

G.  Galeni,  589. 

H.   ruemorrhoidalis,   597 ;    hemi- 
azygos,   595  ;     hepatic®,   596  ; 
hypogastrica,  597. 
I.  iliaca  communis,  597  ;  externa, 
597;  jugularis  externa  anter., 
593  ;  poster.,  593  ;  interna,  592. 
L.  Jabiales,  592  ;  lienis,  598 ;  lin- 
gualis,  593 ;  lumbalis  ascend., 
595. 

M.  magna  cordis,  589  ;  Galeni  s. 
brain,  mammaria,  591  ;  mastoi- 
deae,  592 ;  maxillaris  interna, 
592 ;  mediana,  594  ;  mesenteri- 
cae,  598  ;  minores  cordis,  589. 
O.  occipital.,  592;  ophthalmic., 

592 ;  ovaricas,  596. 
P.  palatine,  592;  parotideae,  592; 
portarum,  598  ;  pudenda,  596 ; 
pulmonales,  536. 
R.  raninae,  593 ;  renales,  595. 
S.  salvatella,  594  ;  saphenaa,  597  ; 
spermaceticae,    596  ;     spinales, 
600  ;  splenica,  598  ;  subclavia, 
594 ;  subscapular,  594. 
T.  temporales,  592  ;  thyreoideae, 
591,    592;     testiculares,    596; 
transversa    colli  and  scapulae, 
593. 

U.  umbilicalis,  599. 
V.    vertebralis,   591 ;    vesicales, 

597 ;  vorticosae,  592. 
Ventriculus,  436. 

Ventriculi :     cordis,    527 ;    laterales, 
620  ;  Morgagni,  464  ;  quartus,  620 ; 
septi  pellucidi,  623  ;  tertius,  620. 
Vermis,  622. 
Vertebrae,  75. 
Veru  montanum,  473. 
Vesica  fellea,  447 ;  urinaria,  472. 
Vesiculae  :     germinativa,    483,    484 ; 
Graafian.,  484;    pulmonales,  467; 
seminales,  479. 


INDEX. 


487 


Vestibulum,  512  ;  vaginae,  488. 

Vibrissae,  518. 

Villi,  438. 

Virga,  482. 

Viscera,  426. 

Vomer,  65. 

Vulva,  488. 


Zona  ciliaris,  504  ;  iridis,  500  ;   Val- 

salves,  514,  515. 
Zonula  Zinnii,  504 ;  ossea  lam.  spiral., 

514. 


THE    END. 


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